Provider Demographics
NPI:1184966210
Name:UCLA HEALTH SYSTEMS
Entity type:Organization
Organization Name:UCLA HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:MERIBETH
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:MSN NP
Authorized Official - Phone:310-794-9206
Mailing Address - Street 1:200 MEDICAL PLZ
Mailing Address - Street 2:SUITE 660
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-0001
Mailing Address - Country:US
Mailing Address - Phone:310-794-9206
Mailing Address - Fax:310-794-9630
Practice Address - Street 1:200 MEDICAL PLZ
Practice Address - Street 2:SUITE 660
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-794-9206
Practice Address - Fax:310-794-9630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA655119261Q00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center