Provider Demographics
NPI:1558662999
Name:UCLA MEDICAL CENTER
Entity Type:Organization
Organization Name:UCLA MEDICAL CENTER
Other - Org Name:UCLA
Other - Org Type:Other Name
Authorized Official - Title/Position:PROGRAM RESIDENCY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDOLPH
Authorized Official - Middle Name:
Authorized Official - Last Name:STEADMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-825-4321
Mailing Address - Street 1:757 WESTWOOD BLVD
Mailing Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-7403
Mailing Address - Country:US
Mailing Address - Phone:310-267-8655
Mailing Address - Fax:
Practice Address - Street 1:757 WESTWOOD PLZ
Practice Address - Street 2:DEPT OF ANESTHESIOLOGY
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-7403
Practice Address - Country:US
Practice Address - Phone:310-267-8655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA106217390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty