Provider Demographics
NPI:1669848842
Name:LAC USC MEDICAL CENTER
Entity Type:Organization
Organization Name:LAC USC MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ARJUN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-307-1151
Mailing Address - Street 1:41 CEDAR WALK UNIT 4308
Mailing Address - Street 2:UNIT 4308
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-7919
Mailing Address - Country:US
Mailing Address - Phone:323-307-1151
Mailing Address - Fax:
Practice Address - Street 1:41 CEDAR WALK UNIT 4308
Practice Address - Street 2:UNIT 4308
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-7919
Practice Address - Country:US
Practice Address - Phone:323-307-1151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital