Provider Demographics
NPI:1639282726
Name:HARBOR-UCLA MEDICAL FOUNDATION INC.
Entity Type:Organization
Organization Name:HARBOR-UCLA MEDICAL FOUNDATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:STRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-222-5015
Mailing Address - Street 1:PO BOX 30380
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90030-0380
Mailing Address - Country:US
Mailing Address - Phone:310-222-5015
Mailing Address - Fax:310-222-5027
Practice Address - Street 1:15107 VANOWEN ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4542
Practice Address - Country:US
Practice Address - Phone:310-222-5015
Practice Address - Fax:310-222-5027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0009904Medicaid