Provider Demographics
NPI:1235599598
Name:WHITE MEMORIAL MEDICAL CENTER
Entity type:Organization
Organization Name:WHITE MEMORIAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCILA
Authorized Official - Middle Name:
Authorized Official - Last Name:TARIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-226-1100
Mailing Address - Street 1:259 N EUCLID AVE
Mailing Address - Street 2:APT 12
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:259 N EUCLID AVE
Practice Address - Street 2:APT 12
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1516
Practice Address - Country:US
Practice Address - Phone:323-226-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA140212261Q00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center