Healthcare Provider Details

I. General information

NPI: 1316464068
Provider Name (Legal Business Name): SOWMYA G MURTHY CARE COORDINATOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2017
Last Update Date: 08/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 SO LAFAYETTE PARK PLACE 3RD FLOOR
LA CA
90057-5400
US

IV. Provider business mailing address

3424 WILSHIRE BLVD STE 100
LOS ANGELES CA
90010-2262
US

V. Phone/Fax

Practice location:
  • Phone: 323-932-1226
  • Fax: 213-383-3146
Mailing address:
  • Phone: 323-932-1226
  • Fax: 323-933-9808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: