1841724168 NPI number — UNIVERSITY OF SOUTHERN CALIFORNIA

Table of content: (NPI 1841724168)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841724168 NPI number — UNIVERSITY OF SOUTHERN CALIFORNIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF SOUTHERN CALIFORNIA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841724168
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/09/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
925 W. 34TH STREET
Provider Second Line Business Mailing Address:
DEN B23
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90089-2212
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
213-740-1637
Provider Business Mailing Address Fax Number:
213-740-8663

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
545 S. SAN PEDRO STREET
Provider Second Line Business Practice Location Address:
SECOND FLOOR
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90013-2101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-347-6300
Provider Business Practice Location Address Fax Number:
213-673-4582
Provider Enumeration Date:
04/13/2017

Additional Information

Authorized Official

Authorized Official Last Name:
TODD
Authorized Official First Name:
MARK
Authorized Official Middle Name:
K.
Authorized Official Title or Position:
VICE PROVOST ACADEMIC OPERATIONS
Authorized Official Telephone Number:
213-821-4400

Provider Taxonomy Codes

  • Taxonomy code: 122300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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