Organization
USC CARDIOTHORACIC SURGEON'S
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC ALCORN (EXECUTIVE VICE PRESIDENT)
(323) 442-5923
Entity
Organization
Contact information
Practice address
1520 SAN PABLO ST, SUITE 4300, LOS ANGELES, CA 90033-5310
(323) 442-5923
(323) 442-6798
Mailing address
1520 SAN PABLO ST, SUITE 4300, LOS ANGELES, CA 90033-5310
(323) 442-5923
(323) 442-6798
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CF9747
MEDICARE RR
CA
05
—
GR0084570
—
CA
Enumeration date
08/13/2006
Last updated
02/05/2008
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