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NPI Code Detail

MEDICARE: EDWARD THOMAS WASLOSKI

MEDICARE: EDWARD THOMAS WASLOSKI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist95002234CA

General Provider Information

NPI Number : 1033780192
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWARD THOMAS WASLOSKI
Provider Business Mailing Address
First Line : 2500 ABBOT KINNEY BLVD APT 23
Second Line :
City : VENICE
State : CA
Zip : 90291-4797
Country : US
Telephone Number : 410-707-4237
Fax Number :
Provider Business Practice Location Address
First Line : 4867 W SUNSET BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90027-5969
Country : US
Telephone Number : 833-574-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2021
Last Update Date : 06/22/2026

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Directions to “ EDWARD THOMAS WASLOSKI ” Practice Location

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