Organization
UCLA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS VALENCIA (CREDENTIALING SPECIALIST)
(310) 267-5986
Entity
Organization
Contact information
Practice address
1010 VETERAN AVE, WEST MEDICAL BUILDING, ROOM 2212E, LOS ANGELES, CA 90024-2704
(310) 825-4965
Mailing address
1010 VETERAN AVE, ROOM 2212E WEST MEDICAL BUILDING, LOS ANGELES, CA 90024
(310) 825-4965
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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