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Organization
UNIVERSITY OF SOUTHERN CALIFORNIA
Active
Organization
UNIVERSITY OF SOUTHERN CALIFORNIA
Active
Other names
USC MEDICAL PLAZA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RUDOLPH RPH (EXECUTIVE DIRECTOR)
(323) 442-1354
Entity
Organization
Contact information
Practice address
1510 SAN PABLO ST, STE 144, LOS ANGELES, CA 90033-5320
(323) 442-5770
(323) 442-5970
Mailing address
1510 SAN PABLO ST, STE 144, LOS ANGELES, CA 90033-4604
(323) 442-5770
(323) 442-5970
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY37195
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679676639
—
CA
01
—
1996506
PK
—
Enumeration date
09/06/2006
Last updated
07/19/2018
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