Provider Demographics
NPI:1225299522
Name:LAC USC
Entity Type:Organization
Organization Name:LAC USC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:BEN-ARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-226-7556
Mailing Address - Street 1:410 S EUCLID AVE
Mailing Address - Street 2:APT#2
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-3159
Mailing Address - Country:US
Mailing Address - Phone:626-679-5256
Mailing Address - Fax:
Practice Address - Street 1:2020 ZONAL AVE # IRD620
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0121
Practice Address - Country:US
Practice Address - Phone:323-226-7556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-19
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA103771282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital