MEDICARE: EMILY RUS

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	104100000X	Social Worker	89056	CA

General Provider Information

NPI Number	:	1518634526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY RUS

Provider Business Mailing Address
First Line	:	8011 ROMAINE ST APT 107
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90046-6063
Country	:	US
Telephone Number	:	585-734-8667
Fax Number	:

Provider Business Practice Location Address
First Line	:	12100 WILSHIRE BLVD FL 8
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-7120
Country	:	US
Telephone Number	:	310-896-5568
Fax Number	:

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

Provider Enumeration Date	:	08/26/2021
Last Update Date	:	08/26/2021

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Directions to “ EMILY RUS ” Practice Location

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