MEDICARE: MRS. VERONICA C RECZEK N.P

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	363L00000X	Nurse Practitioner	NP18411	CA
2	363LF0000X	Family Nurse Practitioner	18411	CA

General Provider Information

NPI Number	:	1871741488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VERONICA C RECZEK N.P

Provider Business Mailing Address
First Line	:	2143 S SEPULVEDA BLVD
Second Line	:	SUITE 300
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5733
Country	:	US
Telephone Number	:	310-575-3100
Fax Number	:	310-575-3102

Provider Business Practice Location Address
First Line	:	2143 S SEPULVEDA BLVD
Second Line	:	SUITE 300
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5733
Country	:	US
Telephone Number	:	310-575-3100
Fax Number	:	310-575-3102

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

Provider Enumeration Date	:	09/08/2008
Last Update Date	:	06/30/2011

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Directions to “ MRS. VERONICA C RECZEK N.P” Practice Location

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