Healthcare Provider Details

I. General information

NPI: 1760337117
Provider Name (Legal Business Name): KATHERINE GORMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIT GORMAN

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8280 SANTA MONICA BLVD
WEST HOLLYWOOD CA
90046-5915
US

IV. Provider business mailing address

9201 W SUNSET BLVD
WEST HOLLYWOOD CA
90069-3701
US

V. Phone/Fax

Practice location:
  • Phone: 310-550-1010
  • Fax:
Mailing address:
  • Phone: 310-550-1010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95038711
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number95134526
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: