Organization
CHILDREN'S HOSPITAL LOS ANGELES MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES LIN (CHIEF FINANCIAL OFFICER)
(323) 361-1601
Entity
Organization
Contact information
Practice address
4650 W SUNSET BLVD, MS# 116, LOS ANGELES, CA 90027-6062
(323) 361-4131
Mailing address
3250 WILSHIRE BLVD STE 1101, LOS ANGELES, CA 90010-1513
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G90877-01
—
CA
Enumeration date
07/05/2007
Last updated
07/01/2024
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