| Lac Harbor Ucla Medical Center | |
|
1403 Lomita Blvd Ste 200 Harbor City CA 90710-2086 | |
| (310) 534-6203 | |
| Not Available |
| Full Name | Lac Harbor Ucla Medical Center |
|---|---|
| Speciality | Clinic/center |
| Location | 1403 Lomita Blvd Ste 200, Harbor City, California |
| Authorized Official Name and Position | Arthur Bernal (ASSOCIATE HOSPITAL ADMINISTRATOR) |
| Authorized Official Contact | 3238907774 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lac Harbor Ucla Medical Center 1000 W Carson St Torrance CA 90502-2004 Ph: (310) 222-2101 | Lac Harbor Ucla Medical Center 1403 Lomita Blvd Ste 200 Harbor City CA 90710-2086 Ph: (310) 534-6203 |
| NPI Number | 1073955985 |
|---|---|
| Provider Enumeration Date | 07/19/2013 |
| Last Update Date | 07/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073955985 | NPI | - | NPPES |
| HAP40376F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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