Basic Information
Provider Information
NPI: 1073637567
EntityType: 2
ReplacementNPI:  
OrganizationName: PARA LOS NINOS
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5000 HOLLYWOOD BLVD.
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 90027
CountryCode: US
TelephoneNumber: 2132504800
FaxNumber: 2132504900
Practice Location
Address1: 849 E 6TH ST
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900211026
CountryCode: US
TelephoneNumber: 2136238446
FaxNumber: 2138961880
Other Information
ProviderEnumerationDate: 03/19/2007
LastUpdateDate: 05/09/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: FUREDI
AuthorizedOfficialFirstName: ANDREW
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT & CEO
AuthorizedOfficialTelephone: 2132504800
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: PH.D
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X  Y AgenciesCommunity/Behavioral Health 

No ID Information.


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