Provider Demographics
NPI:1104096577
Name:LOS ANGELES COUNTY USC MEDICAL CENTER
Entity type:Organization
Organization Name:LOS ANGELES COUNTY USC MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CARDIOTHORACIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:LEO
Authorized Official - Last Name:MONTERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-442-5849
Mailing Address - Street 1:14227 MAGNOLIA BLVD APT H304
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-1081
Mailing Address - Country:US
Mailing Address - Phone:818-203-4304
Mailing Address - Fax:818-386-2954
Practice Address - Street 1:1520 SAN PABLO ST
Practice Address - Street 2:SUITE 4300
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-5310
Practice Address - Country:US
Practice Address - Phone:323-442-5849
Practice Address - Fax:323-442-6851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-02
Last Update Date:2008-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85344282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access