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Organization
USC FAMILY MEDICINE INC
Active
Organization
USC FAMILY MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARRIE NICHOLS M.D. (MEDICAL DIRECTOR)
(213) 741-1102
Entity
Organization
Contact information
Practice address
1400 S GRAND AVE, SUITE 101, LOS ANGELES, CA 90015-3048
(213) 744-0801
(213) 741-1434
Mailing address
1400 S GRAND AVE, SUITE 101, LOS ANGELES, CA 90015-3048
(213) 744-0801
(213) 741-1434
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0057011
—
CA
Enumeration date
02/08/2007
Last updated
08/22/2020
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