Provider Demographics
NPI:1639362981
Name:WOMENS AND CHILDRENS HOSPITAL
Entity Type:Organization
Organization Name:WOMENS AND CHILDRENS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PGY-3 OB/GYN
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:FELIX-TRUNNELLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-240-6671
Mailing Address - Street 1:1240 NORTH MISISON ROAD
Mailing Address - Street 2:ROOM 5K-13
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033
Mailing Address - Country:US
Mailing Address - Phone:909-240-6671
Mailing Address - Fax:
Practice Address - Street 1:1240 NORTH MISISON RD
Practice Address - Street 2:ROOM 5K-13
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:909-240-6671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97330282NW0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NW0100XHospitalsGeneral Acute Care HospitalWomen