Provider Demographics
NPI:1447821285
Name:USC CARE MEDICAL GROUP, INC
Entity type:Organization
Organization Name:USC CARE MEDICAL GROUP, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE CHAIR
Authorized Official - Prefix:
Authorized Official - First Name:NARSING
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-442-5551
Mailing Address - Street 1:PO BOX 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:323-442-9879
Mailing Address - Fax:
Practice Address - Street 1:2011 ZONAL AVE STE 301
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-1016
Practice Address - Country:US
Practice Address - Phone:323-442-9879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:USC CARE MEDICAL GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-02
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory