Provider Demographics
NPI:1346316551
Name:UCLA ARTHUR ASHE STUDENT HEALTH AND WELLNESS CENTER
Entity Type:Organization
Organization Name:UCLA ARTHUR ASHE STUDENT HEALTH AND WELLNESS CENTER
Other - Org Name:ASHE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER OF IT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-206-6356
Mailing Address - Street 1:221 WESTWOOD PLZ
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-1703
Mailing Address - Country:US
Mailing Address - Phone:310-825-4073
Mailing Address - Fax:310-206-2747
Practice Address - Street 1:221 WESTWOOD PLZ
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-1703
Practice Address - Country:US
Practice Address - Phone:310-825-4073
Practice Address - Fax:310-206-2747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health