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Organization

UCLA HOSPITAL DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ROSA M. GONZALEZ MSO III (OPERATIONS MANAGER)
(310) 206-6926
Entity
Organization

Contact information

Practice address
UCLA HOSPITAL DENTISTRY, 10833 LE CONTE AVE. CHS BLDG ROOM A0-156B, LOS ANGELES, CA 90095-0001
(310) 206-8775
(310) 206-4201
Mailing address
P.O. BOX 84582, UCLA HOSPITAL DENTISTRY, LOS ANGELES, CA 90073
(310) 206-8775
(310) 206-4210

Taxonomy

Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
D19585
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
G91297-01
CA
Enumeration date
12/27/2007
Last updated
12/27/2007
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