| Program: | Name: | Fee: | Fax #: |
| Anesthesia | Wayne Hasby | $50 standard form
$75 form filled out by program director | 310-267-3766 |
| Emergency Medicine | Jennifer Cassidy | $50 (payable by check only) | 310-794-0599 |
| Family Medicine | Christine Morguen | $50 standard form and/or letter of verification
$100 standard form including request for hospital seal
$125 notarized
| 310-453-5106 |
| FM-Sports Medicine | Christine Morguen | $50 standard form and/or letter of verification
$100 standard form including request for hospital seal
$125 notarized | 310-453-5106 |
| Internal Medicine | Libby Shin | $50 | |
| IM-Allergy/Immunology | Giovanna Alvarado | | 310-825-9832 |
| IM-Cardiology | Desiree Valeriano | $75 | 310-206-9133 |
| IM-Dermatology | Hanna Lambertson | | 310-825-3613 |
| IM-Endocrinology | Jayamalee De Silva | | 310-312-0546 |
| IM-Gastroenterology | Teresa Olivas | $50 standard form
$100 custom verification letter | 310-267-1861 |
| IM-Geriatrics | Alina Pogorelova | | 310-794-2199 |
| IM-Hematology/Oncology | CJ Cabrera | $75 for outside agencies and institutions | 310-206-3289 |
| IM-Hospice & Palliative | Robin Catino | | 310-268-4818 |
| IM-Infectious Diseases | Izumi Shitoma | | 310-825-3632 |
| IM-Nephrology | Reggie Mateo | $100 for outside agencies and institutions | 310-825-6309 |
| IM-Preventive Medicine | Meghan Narikawa | | 310-267-3840 |
| IM-Pulmonary/Critical Care | Heather Draper | $50 standard form
$75 form filled out by program director | 310-206-8622 |
| IM-Rheumatology | Sara Delgado | | 310-206-8606 |
| IM-Sleep Medicine | Heather Draper | $50 standard form
$75 form filled out by program director | 310-206-8622 |
| Medicine-Pediatrics | Meghan Narikawa | | 310-267-3840 |
| Neurology (Residencies & Fellowships) | Samantha Dearn | $50 for outside agencies and institutions | 310-206-4733 |
| Nuclear Medicine | Jose Terrazas | | 310-206-4899 |
| OB/Gyn (Residency) | Nicole Santos | $50 standard form
$75 form filled out by Program Director
$100 notarized | 310-206-7186 |
| OB/Gyn (Fellowship) | Yissel Rojas | $50 standard form
$75 form filled out by Program Director
$100 notarized | 310-206-7186 |
| Ophthalmology | Debbie Sato | | 310-825-4617 |
| Orthopaedic Surgery | Connie Sams | $50 | 310-825-1311 |
| Pathology (Residency) | Annetta Pierro | $30 standard letter
$40 filled out by the program director
$50 notarized | 310-267-2058 |
| Path - Bloodbanking/Transfusion Medicine Path - Hematopathology | Xiajian (Jayne) Lu | $30 standard letter
$40 filled out by the program director
$50 notarized | |
| Path - Cytopathology Path - Dermatopathology Path - Molecular Genetic Pathology Path - Neuropathology | Heidi Merkin | $30 standard letter
$40 filled out by the program director
$50 notarized | |
| Pediatrics (Residency) | Jacquelyn Voet | $50 | 310-267-3842 |
| Pediatrics (Fellowships) | Laura Guerrero | $50 | 310-825-6394 |
| Pediatric Neurology (Child Neurology, Peds Epilepsy, BrainSport) | Raquel Gallegos | | 310-825-5834 |
| Psychiatry (Residency & Fellowships) | Denise Aguinaldo | | 310-825-0340 |
| Radiation Oncology | Kathy Rose | | 310-794-1984 |
| Radiology (Residency & Fellowships) | Lara Gold | $50 standard letter
$100 filled out by the program director
$150 notarized | 310-825-5806 |
| Surgery-General | Chi Quach | $75 | 310-267-0369 |
| Surgery-Head & Neck | Christina Burton | | 310-206-1393 |
| Surgery-Neurosurgery | Colleen Bruton | $30 program coordinator signature
$50 program director signature
$50 hospital seal
$60 custom letter | 310-267-2707 |
| Surgery-Plastic | Bryan Carrigan | | 310-825-5582 |
| Surgery-Thoracic | Desiree Valeriano | | 310-267-0369 |
| Surgery-Vascular | Maria Velasco | $50 for outside agencies and institutions | 310-267-0189 |
| Urology (Residency) | Nicole Santos | $50 standard form
$75 form filled out by Program Director
$100 notarized | 310-206-7186 |
| Urology (Fellowship) | Yissel Rojas | $50 standard form
$75 form filled out by Program Director
$100 notarized | 310-206-7186 |
