Provider Demographics
NPI:1003238304
Name:USC TELEHEALTH
Entity Type:Organization
Organization Name:USC TELEHEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MSW INTERN
Authorized Official - Prefix:
Authorized Official - First Name:LEYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-908-4168
Mailing Address - Street 1:1232 1/2 E APPLETON ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-3663
Mailing Address - Country:US
Mailing Address - Phone:310-908-4168
Mailing Address - Fax:
Practice Address - Street 1:1232 1/2 E APPLETON ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-3663
Practice Address - Country:US
Practice Address - Phone:310-908-4168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty