MEDICARE: MS. ALTHEA MONICA HUNTER CRNA

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
1	367500000X	Certified Registered Nurse Anesthetist	731	CA

General Provider Information

NPI Number	:	1417086091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALTHEA MONICA HUNTER CRNA

Provider Business Mailing Address
First Line	:	11260 OVERLAND AVE - 8D
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230
Country	:	US
Telephone Number	:	310-838-8508
Fax Number	:

Provider Business Practice Location Address
First Line	:	11260 OVERLAND AVE APT 8D
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-5531
Country	:	US
Telephone Number	:	310-838-8508
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	07/08/2007

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