Organization
AURORA CHARTER OAK-LOS ANGELES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD SMITH (CHIEF EXECUTIVE OFFICER)
(626) 966-1632
Entity
Organization
Contact information
Practice address
1161 E COVINA BLVD, COVINA, CA 91724-1523
(626) 966-1632
(626) 859-5292
Mailing address
1161 E COVINA BLVD, COVINA, CA 91724-1523
(626) 966-1632
(626) 859-5292
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HSM34069H
—
CA
05
—
HSP34069H
—
CA
05
—
HSP44069H
—
CA
Enumeration date
04/27/2006
Last updated
08/22/2020
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