Provider Demographics
NPI:1710514930
Name:LOS ANGELES MEDICAL CENTER FOUNDATION
Entity Type:Organization
Organization Name:LOS ANGELES MEDICAL CENTER FOUNDATION
Other - Org Name:LOS ANGELES MEDICAL CENTER FOUNDATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROMINA
Authorized Official - Middle Name:
Authorized Official - Last Name:JURIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-483-2620
Mailing Address - Street 1:2010 WILSHIRE BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-3507
Mailing Address - Country:US
Mailing Address - Phone:213-483-9209
Mailing Address - Fax:213-483-0250
Practice Address - Street 1:2010 WILSHIRE BLVD FL 2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3507
Practice Address - Country:US
Practice Address - Phone:213-483-9209
Practice Address - Fax:213-483-0250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-26
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty