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Organization

UNIVERSITY OF SOUTHERN CALIFORNIA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD JENNELLE MD (PROGRAM DIRECTOR)
(323) 409-5010
Entity
Organization

Contact information

Practice address
1200 N STATE ST, LOS ANGELES, CA 90033-1029
(323) 409-5010
Mailing address
1200 N STATE ST, LOS ANGELES, CA 90033-1029

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary

Other

Enumeration date
04/30/2013
Last updated
09/27/2014
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