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Organization
LAC/USC VIP CLINIC
Active
Organization
LAC/USC VIP CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER PEREZ M.P.A. (PROGRAM MANAGER)
(323) 226-5217
Entity
Organization
Contact information
Practice address
2010 ZONAL AVE., OPD 3P61, LOS ANGELES, CA 90033
(323) 226-3961
(323) 226-2573
Mailing address
2010 ZONAL AVE., OPD 3P61, LOS ANGELES, CA 90033
(323) 226-3961
(323) 226-2573
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18548
CA
Other
Enumeration date
04/14/2010
Last updated
04/14/2010
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