Provider Demographics
NPI:1548678360
Name:UCLA PATHOLOGY RESIDENCY PROGRAM
Entity type:Organization
Organization Name:UCLA PATHOLOGY RESIDENCY PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EDUCATION COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-825-5719
Mailing Address - Street 1:10833 LE CONTE AVE,
Mailing Address - Street 2:13-145G CHS
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095
Mailing Address - Country:US
Mailing Address - Phone:310-825-5719
Mailing Address - Fax:310-267-2058
Practice Address - Street 1:10833 LE CONTE AVE,
Practice Address - Street 2:13-145G CHS
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095
Practice Address - Country:US
Practice Address - Phone:310-825-5719
Practice Address - Fax:310-267-2058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory