Provider Demographics
NPI:1184655417
Name:TENET HEALTHSYSTEM NORRIS, INC.
Entity Type:Organization
Organization Name:TENET HEALTHSYSTEM NORRIS, INC.
Other - Org Name:USC KENNETH NORRIS JR. CANCER HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF GOVT PROGRAMS, TENET
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:C
Authorized Official - Last Name:ARMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-775-8043
Mailing Address - Street 1:PO BOX 57514
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-0001
Mailing Address - Country:US
Mailing Address - Phone:626-300-4122
Mailing Address - Fax:323-865-0960
Practice Address - Street 1:1441 EASTLAKE AVE.
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-865-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA930000267284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
0006159240OtherAETNA US HEALTHCARE
CAHSC30660FMedicaid
050660OtherBLUE CROSS
050660OtherBLUE CROSS
=========OtherUNITED HEALTHCARE
0006159240OtherAETNA US HEALTHCARE
CAHSC30660FMedicaid