Provider Demographics
NPI:1194936856
Name:HARBOR-UCLA
Entity type:Organization
Organization Name:HARBOR-UCLA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:EGGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-304-2997
Mailing Address - Street 1:348 HAUSER BLVD
Mailing Address - Street 2:409
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3276
Mailing Address - Country:US
Mailing Address - Phone:323-954-0885
Mailing Address - Fax:
Practice Address - Street 1:1000 W CARSON ST
Practice Address - Street 2:BOX 17
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2004
Practice Address - Country:US
Practice Address - Phone:310-222-1811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital