Provider Demographics
NPI:1558819391
Name:UNIVERSITY OF SOUTHERN CALIFORNIA
Entity Type:Organization
Organization Name:UNIVERSITY OF SOUTHERN CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PROFESSOR
Authorized Official - Prefix:
Authorized Official - First Name:MIN JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:LU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-865-3962
Mailing Address - Street 1:1441 EASTLAKE AVENUE, SUITE 3440
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-4972
Mailing Address - Country:US
Mailing Address - Phone:323-865-3962
Mailing Address - Fax:323-865-0061
Practice Address - Street 1:1441 EASTLAKE AVENUE, SUITE 3440
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-4972
Practice Address - Country:US
Practice Address - Phone:323-865-3962
Practice Address - Fax:323-865-0061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC130396282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital