MEDICARE: LAUSC MEDICAL CENTER

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	282NW0100X	Women's Hospital	16366	CA

General Provider Information

NPI Number	:	1679725980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAUSC MEDICAL CENTER

Provider Business Mailing Address
First Line	:	5516 MAGNOLIA AVE
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90601-2750
Country	:	US
Telephone Number	:	562-695-1507
Fax Number	:

Provider Business Practice Location Address
First Line	:	1240 N MISSION RD RM 2L33
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-1019
Country	:	US
Telephone Number	:	323-226-3106
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DOCTOR
Name	:	ROBERT ISREAL
Credential	:
Telephone Number	:	323-226-3106

Provider Enumeration Date	:	10/17/2008
Last Update Date	:	10/17/2008

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Directions to “LAUSC MEDICAL CENTER ” Practice Location

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