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Organization

COUNTY OF LOS ANGELES AUDITOR CONTROLLER

Active
Other names
County of Los Angeles -Rancho Los Amigos
Organization subpart
No

Provider details

NPI number
Authorized official
MINDY AISEN MD (MEDICAL DIRECTOR)
(562) 803-0124
Entity
Organization

Contact information

Practice address
7601 IMPERIAL HWY, DOWNEY, CA 90242-3456
(562) 803-0124
(562) 803-5569
Mailing address
PO BOX 514316, TERMINAL ANNEX, LOS ANGELES, CA 90051-2316
(562) 803-0124
(562) 803-5569

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
367500000X
Certified Registered Nurse Anesthetist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
M052014
MEDICARE NUMBER
CA
Enumeration date
09/12/2006
Last updated
04/14/2010
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