MEDICARE: LOS ANGELES DOCTORS CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	283Q00000X	Psychiatric Hospital	953910448	CA
2	282N00000X	General Acute Care Hospital

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639195175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOS ANGELES DOCTORS CORP

Provider Business Mailing Address
First Line	:	2231 SOUTH WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018
Country	:	US
Telephone Number	:	323-730-7300
Fax Number	:	949-732-4671

Provider Business Practice Location Address
First Line	:	2231 SOUTH WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018
Country	:	US
Telephone Number	:	323-730-7300
Fax Number	:	949-732-4671

Authorized Official
Title or Position	:	VP/HOSPITAL CFO
Name	:	MR. GARY LEWIS
Credential	:
Telephone Number	:	323-377-6842

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	07/06/2012

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Directions to “LOS ANGELES DOCTORS CORP ” Practice Location

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