Provider Demographics
NPI:1619007374
Name:COUNTY OF LOS ANGELES AUDITOR CONTROLLER
Entity Type:Organization
Organization Name:COUNTY OF LOS ANGELES AUDITOR CONTROLLER
Other - Org Name:LAC RANCHO LOS AMIGOS NATIONAL REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-401-7346
Mailing Address - Street 1:7601 IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-3456
Mailing Address - Country:US
Mailing Address - Phone:562-401-6677
Mailing Address - Fax:
Practice Address - Street 1:7601 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-3456
Practice Address - Country:US
Practice Address - Phone:562-401-6677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF LOS ANGELES AUDITOR CONTROLLER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60000161282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHSD32014FMedicaid