Provider Demographics
NPI:1093850752
Name:LA COUNTY KING DREW MEDICAL CENTER
Entity Type:Organization
Organization Name:LA COUNTY KING DREW MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNM
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBABEH
Authorized Official - Middle Name:AKHAVAN
Authorized Official - Last Name:AZARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-668-4611
Mailing Address - Street 1:10142 BIRCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-5433
Mailing Address - Country:US
Mailing Address - Phone:714-968-4484
Mailing Address - Fax:
Practice Address - Street 1:12021 WILMINGTON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059-3019
Practice Address - Country:US
Practice Address - Phone:310-668-4611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NW0100XHospitalsGeneral Acute Care HospitalWomen
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA273373OtherREGISTERED NURSE
CA03045OtherACNM CERTIFICATION NUMBER
CA163OtherNURSE-MIDWIFE
CA1723OtherNURSE PRACTITIONER NUMBER
CA163OtherNURSE-MIDWIFE FURNISHING
CAMA1271838OtherDEA NUMBER