Organization
UTI-EHRLICH MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDIE GARNETT (MANAGER)
(310) 825-6865
Entity
Organization
Contact information
Practice address
100 UCLA MEDICAL PLZ, SUITE 690, LOS ANGELES, CA 90095-0001
(310) 825-6865
(310) 206-6600
Mailing address
100 UCLA MEDICAL PLZ, SUITE 690, LOS ANGELES, CA 90095-0001
(310) 825-6865
(310) 206-6600
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G14024
CA
2088P0231X
Pediatric Urology Physician
G14024
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0962904
CLIA
CA
Enumeration date
04/06/2007
Last updated
07/18/2012
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