Healthcare Provider Details

I. General information

NPI: 1700698131
Provider Name (Legal Business Name): PAULINE ANN TORIO SMITH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. PAULINE ANN CAOILI TORIO

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2051 MARENGO ST
LOS ANGELES CA
90033-1352
US

IV. Provider business mailing address

717 W OLYMPIC BLVD APT 1104
LOS ANGELES CA
90015-1674
US

V. Phone/Fax

Practice location:
  • Phone: 323-409-1000
  • Fax:
Mailing address:
  • Phone: 323-302-1492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number95088426
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number95030991
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95030991
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: