Provider Demographics
NPI:1689052797
Name:LAC-USC MED CENTER
Entity Type:Organization
Organization Name:LAC-USC MED CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIR OF THE DEPARTMENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:OPAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:1323-226-5721
Mailing Address - Street 1:2323 FLINTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-1024
Mailing Address - Country:US
Mailing Address - Phone:818-952-3312
Mailing Address - Fax:
Practice Address - Street 1:2323 FLINTRIDGE DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-1024
Practice Address - Country:US
Practice Address - Phone:818-952-3312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53566282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital