Provider Demographics
NPI:1194963595
Name:LAC-USC
Entity type:Organization
Organization Name:LAC-USC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINITSTRATIVE SERVICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAGONEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-869-8242
Mailing Address - Street 1:3271 S SEPULVEDA BLVD
Mailing Address - Street 2:302
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-5221
Mailing Address - Country:US
Mailing Address - Phone:720-341-3008
Mailing Address - Fax:
Practice Address - Street 1:1200 N STATE ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1029
Practice Address - Country:US
Practice Address - Phone:323-226-7556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital