Basic Information
| Provider Information | |||||||||
| NPI: | 1528383072 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CEDARS SINAI MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8635 W 3RD ST | ||||||||
| Address2: | SUITE 795 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900486101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104238350 | ||||||||
| FaxNumber: | 3104238351 | ||||||||
| Practice Location | |||||||||
| Address1: | 8635 W 3RD ST | ||||||||
| Address2: | SUITE 795 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900486101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104238350 | ||||||||
| FaxNumber: | 3104238351 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2010 | ||||||||
| LastUpdateDate: | 03/28/2010 | ||||||||
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| AuthorizedOfficialLastName: | KOHAGURA | ||||||||
| AuthorizedOfficialFirstName: | ROSALINA | ||||||||
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| AuthorizedOfficialTitleorPosition: | REGISTERED NURSE | ||||||||
| AuthorizedOfficialTelephone: | 3102591623 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | NP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 19261 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.