Provider Demographics
NPI:1255660171
Name:UCLA
Entity Type:Organization
Organization Name:UCLA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ORA
Authorized Official - Middle Name:
Authorized Official - Last Name:YADIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-206-6987
Mailing Address - Street 1:MATTEL CHILDREN'S HOSPITAL AT UCLA
Mailing Address - Street 2:BOX 951752
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-1752
Mailing Address - Country:US
Mailing Address - Phone:310-206-6987
Mailing Address - Fax:310-825-0442
Practice Address - Street 1:10833 LE CONTE AVE RM A2-383
Practice Address - Street 2:CHS PEDIATRICS BOX 951752
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-1752
Practice Address - Country:US
Practice Address - Phone:310-206-6987
Practice Address - Fax:310-825-0442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-24
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93828281PC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281PC2000XHospitalsChronic Disease HospitalChildren