Basic Information
Provider Information
NPI: 1437253184
EntityType: 2
ReplacementNPI:  
OrganizationName: HARBOR-UCLA MEDICAL FOUNDATION, INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
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Mailing Information
Address1: PO BOX 512079
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900510079
CountryCode: US
TelephoneNumber: 3102225015
FaxNumber: 3102225027
Practice Location
Address1: 1000 W CARSON ST
Address2:  
City: TORRANCE
State: CA
PostalCode: 905022004
CountryCode: US
TelephoneNumber: 3102225015
FaxNumber: 3102225027
Other Information
ProviderEnumerationDate: 09/12/2006
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: STRINGER
AuthorizedOfficialFirstName: WILLIAM
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CHAIR/PRESIDENT
AuthorizedOfficialTelephone: 3102225015
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000X  Y193200000X MULTI-SPECIALTY GROUPOther Service ProvidersSpecialist 

No ID Information.


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