| Lacusc Medical Center | |
|
1200 N State St Los Angeles CA 90033-1029 | |
| (323) 226-2622 | |
| Not Available |
| Full Name | Lacusc Medical Center |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1200 N State St, Los Angeles, California |
| Authorized Official Name and Position | Mark Corbet (INTERIM CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 3232262400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lacusc Medical Center 1200 N State St Los Angeles CA 90033-1029 Ph: (323) 226-2622 | Lacusc Medical Center 1200 N State St Los Angeles CA 90033-1029 Ph: (323) 226-2622 |
| NPI Number | 1356354013 |
|---|---|
| Provider Enumeration Date | 08/14/2006 |
| Last Update Date | 03/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356354013 | NPI | - | NPPES |
| 05S373A000000 | Other | CA | LACUSC 1011 PSYCH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 60000130 (California) | Primary |
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