Organization
COUNTY OF LOS ANGELES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRECK NICHOLS MD (MED PEDS PROGRAM DIRECTOR)
(323) 226-5610
Entity
Organization
Contact information
Practice address
2020 ZONAL AVE RM 115, LOS ANGELES, CA 90089-0121
(323) 226-5610
Mailing address
9314 OLYMPIC BLVD, PICO RIVERA, CA 90660-2142
(562) 443-8904
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
A120119
CA
Other
Enumeration date
03/02/2012
Last updated
03/02/2012
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