Provider Demographics
NPI:1407009269
Name:LOS ANGELES COUNTY PROBATION DEPARTMENT
Entity Type:Organization
Organization Name:LOS ANGELES COUNTY PROBATION DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY PROBATION OFFICER II
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:BRAY
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:323-610-0314
Mailing Address - Street 1:3606 EXPOSITION BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-4822
Mailing Address - Country:US
Mailing Address - Phone:323-298-3511
Mailing Address - Fax:
Practice Address - Street 1:3606 W. EXPOSITION BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90016
Practice Address - Country:US
Practice Address - Phone:323-298-3511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291900000XLaboratoriesMilitary Clinical Medical Laboratory