=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508377409
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CURETOLOGY SURGICAL ONCOLOGY MEDICAL CORPORATION & ASSOCIATES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/18/2017
-----------------------------------------------------
Last Update Date | 10/18/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1127 WILSHIRE BLVD STE 1604
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90017-4007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-261-7100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8950 W OLYMPIC BLVD STE 380
-----------------------------------------------------
City | BEVERLY HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90211-3565
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-261-7100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | CAROLE SUZANNE CUTTER
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 213-261-7100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086X0206X
-----------------------------------------------------
Taxonomy Name | Surgical Oncology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------