1336286889 NPI number — DR. REBECCA SOKOL M.D.

Table of content: DR. REBECCA SOKOL M.D. (NPI 1336286889)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336286889 NPI number — DR. REBECCA SOKOL M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOKOL
Provider First Name:
REBECCA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336286889
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/21/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1640 MARENGO ST
Provider Second Line Business Mailing Address:
SUITE 505
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90033-1036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-221-3270
Provider Business Mailing Address Fax Number:
323-225-6284

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1127 WILSHIRE BLVD
Provider Second Line Business Practice Location Address:
SUITE 1400
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90017-3901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-975-9990
Provider Business Practice Location Address Fax Number:
323-975-9998
Provider Enumeration Date:
01/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207VE0102X , with the licence number:  G33698 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1992740450 . This is a "GROUP NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: ZZZ56147Z . This is a "BLUE SHIELD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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