# RONALD REGAN UCLA MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780926634
- **Authorized official:** SUSANA ISABEL PREZA-SCAVO NURSE PRACTITIONER (NURSE PRACTITIONER II)
- **Authorized official phone:** (310) 267-9812

## Contact information

- **Practice address:** 8603 JELLICO AVE, NORTHRIDGE, CA 91325-3103
- **Practice address phone:** (818) 445-4401
- **Mailing address:** 8603 JELLICO AVE, NORTHRIDGE, CA 91325-3103
- **Mailing address phone:** (818) 445-4401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 21427 | CA | Yes |

## Other

- **Enumeration date:** 03/19/2013
- **Last updated:** 03/19/2013