Provider Demographics
NPI:1215193883
Name:UCLA MEDICAL CENTER
Entity Type:Organization
Organization Name:UCLA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STUDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:S
Authorized Official - Last Name:ASANDRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-825-7532
Mailing Address - Street 1:757 WESTWOOD PLAZA, 1ST FLOOR
Mailing Address - Street 2:RONALD REAGAN UCLA MEDICAL CENTER, DEPT OF RADIOLOGY
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-7437
Mailing Address - Country:US
Mailing Address - Phone:310-825-7532
Mailing Address - Fax:
Practice Address - Street 1:757 WESTWOOD PLAZA, 1ST FLOOR
Practice Address - Street 2:RONALD REAGAN UCLA MEDICAL CENTER DEPT OF RADIOLOGY
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-7437
Practice Address - Country:US
Practice Address - Phone:310-825-7532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital