MEDICARE: MRS. CINDY C NAKASUJI NP

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	363LP0200X	Pediatric Nurse Practitioner	17004	CA

General Provider Information

NPI Number	:	1811195852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CINDY C NAKASUJI NP

Provider Business Mailing Address
First Line	:	1 LMU DR # MS 8455
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-2650
Country	:	US
Telephone Number	:	310-338-5275
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 LMU DR # MS 8455
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-2650
Country	:	US
Telephone Number	:	310-338-5275
Fax Number	:

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

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	10/06/2016

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