Basic Information
| Provider Information | |||||||||
| NPI: | 1881744613 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HARBOR UCLA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 W CARSON ST BOX # 462 | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102221648 | ||||||||
| FaxNumber: | 3102225651 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 W CARSON ST # 462 | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905022004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102221648 | ||||||||
| FaxNumber: | 3102225651 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2007 | ||||||||
| LastUpdateDate: | 08/11/2008 | ||||||||
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| AuthorizedOfficialLastName: | ZARGARBASHI | ||||||||
| AuthorizedOfficialFirstName: | ZARI | ||||||||
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| AuthorizedOfficialTitleorPosition: | PSYCHIATRIC SOCIAL WORKER II | ||||||||
| AuthorizedOfficialTelephone: | 3102221648 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | MSW, LCSW | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | 23125 | CA | Y | Hospital Units | Psychiatric Unit |
No ID Information.