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Organization
THE REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Organization
THE REGENTS OF THE UNIVERSITY OF CALIFORNIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE SOUHRADA (DIRECTOR)
(661) 255-2420
Entity
Organization
Contact information
Practice address
4343 LANKERSHIM BLVD STE 210, NORTH HOLLYWOOD, CA 91602-2705
(818) 843-9038
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-5256
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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