Provider Demographics
NPI:1053516559
Name:CEDARS-SINAI MEDICAL CENTER FOUNDATION
Entity type:Organization
Organization Name:CEDARS-SINAI MEDICAL CENTER FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-967-1884
Mailing Address - Street 1:PO BOX 54679
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90054-0679
Mailing Address - Country:US
Mailing Address - Phone:310-967-1884
Mailing Address - Fax:310-967-1744
Practice Address - Street 1:99 N LA CIENEGA BLVD
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2222
Practice Address - Country:US
Practice Address - Phone:310-967-1884
Practice Address - Fax:310-967-1744
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CEDARS-SINAI MEDICAL CENTER FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-15
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW13103LOtherMEDICARE LOCATION NUMBER