| Children's Hospital Los Angeles | |
|
3250 Wilshire Blvd 5th Floor Los Angeles CA 90010-1577 | |
| (323) 671-3849 | |
| Not Available |
| Full Name | Children's Hospital Los Angeles |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 3250 Wilshire Blvd, Los Angeles, California |
| Authorized Official Name and Position | Max Scott Lieberenz (SR.VP/CFO) |
| Authorized Official Contact | 3233612235 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Hospital Los Angeles 8455 Fountain Ave #628 West Hollywood CA 90069-2536 Ph: (310) 266-2382 | Children's Hospital Los Angeles 3250 Wilshire Blvd 5th Floor Los Angeles CA 90010-1577 Ph: (323) 671-3849 |
| NPI Number | 1255455242 |
|---|---|
| Provider Enumeration Date | 03/17/2007 |
| Last Update Date | 10/21/2021 |
| Certification Date | 10/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255455242 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | MFC43890 (California) | Primary |
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