Provider Demographics
NPI:1790718500
Name:USC UNIVERSITY HOSPITAL, INC.
Entity Type:Organization
Organization Name:USC UNIVERSITY HOSPITAL, INC.
Other - Org Name:USC HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF GOVT PROGRAMS, TENET
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:C
Authorized Official - Last Name:ARMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-775-8043
Mailing Address - Street 1:FILE 57446
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-7446
Mailing Address - Country:US
Mailing Address - Phone:209-578-2513
Mailing Address - Fax:805-434-2913
Practice Address - Street 1:1500 SAN PABLO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-5313
Practice Address - Country:US
Practice Address - Phone:323-442-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:USC UNIVERSITY HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-08
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA930000459273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
05-S696Medicare PIN
05-S696Medicare PIN