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NPI Code Detail

MEDICARE: UNIVERSITY OF SOUTHERN CALIFORNIA

MEDICARE: UNIVERSITY OF SOUTHERN CALIFORNIA
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
13336C0003XCommunity/Retail Pharmacy53460CA

General Provider Information

NPI Number : 1790160273
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSITY OF SOUTHERN CALIFORNIA
Provider Business Mailing Address
First Line : 1000 S FREMONT AVE
Second Line : SUITE 10150
City : ALHAMBRA
State : CA
Zip : 91803-8800
Country : US
Telephone Number : 855-885-2600
Fax Number : 626-457-4195
Provider Business Practice Location Address
First Line : 1000 S FREMONT AVE
Second Line : SUITE 10150
City : ALHAMBRA
State : CA
Zip : 91803-8800
Country : US
Telephone Number : 855-885-2600
Fax Number : 626-457-4195
Authorized Official
Title or Position : SVP & CEO, KECK MEDICINE OF USC
Name : MR. THOMAS E. JACKIEWICZ
Credential :
Telephone Number : 855-885-2600
Provider Enumeration Date : 07/24/2015
Last Update Date : 03/19/2026

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Directions to “UNIVERSITY OF SOUTHERN CALIFORNIA ” Practice Location

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