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Organization
CHILDRENS HOSPITAL OF LOS ANGELES
Active
Organization
CHILDRENS HOSPITAL OF LOS ANGELES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAX SCOTT LIEBERENZ CPA (SR.VP/CFO)
(323) 361-2235
Entity
Organization
Contact information
Practice address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(323) 669-2202
(323) 668-7951
Mailing address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(323) 669-2202
(323) 668-7951
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
261QC0050X
Critical Access Hospital Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
282NC2000X
Children's Hospital
Primary
930000032
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
053302
BLUE CROSS
CA
05
—
1189050
—
NV
01
—
681051
CHAMPUS
CA
05
—
HSC30123F
—
CA
05
—
ZZT40123F
—
CA
01
—
ZZZH19032
BLUE SHIELD
CA
Enumeration date
05/24/2006
Last updated
03/18/2025
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