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
—
—
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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