Provider Demographics
NPI:1669895470
Name:UCLA
Entity type:Organization
Organization Name:UCLA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF GERIATRIC MEDICINE
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-206-8272
Mailing Address - Street 1:10943 OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024
Mailing Address - Country:US
Mailing Address - Phone:310-980-5370
Mailing Address - Fax:
Practice Address - Street 1:10943 OHIO AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-5450
Practice Address - Country:US
Practice Address - Phone:310-980-5370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21508282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital