Basic Information
| Provider Information | |||||||||
| NPI: | 1215960984 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GREATER LOS ANGELES HEALTH CARE SYSTEM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16820 EDGAR ST | ||||||||
| Address2: | |||||||||
| City: | PACIFIC PALISADES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902723227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104783711 | ||||||||
| FaxNumber: | 3102684086 | ||||||||
| Practice Location | |||||||||
| Address1: | 11301 WILSHIRE BLVD | ||||||||
| Address2: | BLDG 500 ROOM # 3209 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900731003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104783711 | ||||||||
| FaxNumber: | 3102684086 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BATUMAN | ||||||||
| AuthorizedOfficialFirstName: | FATMA | ||||||||
| AuthorizedOfficialMiddleName: | KHAWAJA | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR, WOMEN'S HEALTH CLINIC | ||||||||
| AuthorizedOfficialTelephone: | 3104783711 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NW0100X | C51537 | CA | Y | Hospitals | General Acute Care Hospital | Women |
No ID Information.