Provider Demographics
NPI:1417364811
Name:COUNTY OF LOS ANGELES - AUDITOR CONTROLLER
Entity Type:Organization
Organization Name:COUNTY OF LOS ANGELES - AUDITOR CONTROLLER
Other - Org Name:LOS ANGELES COUNTY HEALTH SERVICESCENTRAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY SERVICES CHIEF
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DSOUZA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:213-240-7717
Mailing Address - Street 1:313 N FIGUEROA ST
Mailing Address - Street 2:SUITE 1225
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2602
Mailing Address - Country:US
Mailing Address - Phone:213-240-7717
Mailing Address - Fax:213-975-9623
Practice Address - Street 1:313 N FIGUEROA ST
Practice Address - Street 2:SUITE 1225
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2602
Practice Address - Country:US
Practice Address - Phone:213-240-7717
Practice Address - Fax:213-975-9623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-17
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHE 51883261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center