MEDICARE: IVONNE T. JORIF

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	364SM0705X	Medical-Surgical Clinical Nurse Specialist	29	CA

General Provider Information

NPI Number	:	1780959155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVONNE T. JORIF

Provider Business Mailing Address
First Line	:	3632 KALSMAN DR
Second Line	:	#3
City	:	LOS ANGELES
State	:	CA
Zip	:	90016-4416
Country	:	US
Telephone Number	:	310-559-9426
Fax Number	:

Provider Business Practice Location Address
First Line	:	3632 KALSMAN DR
Second Line	:	#3
City	:	LOS ANGELES
State	:	CA
Zip	:	90016-4416
Country	:	US
Telephone Number	:	310-559-9426
Fax Number	:

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

Provider Enumeration Date	:	03/18/2012
Last Update Date	:	03/18/2012

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