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General NPI Number Information
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NPI Number | 1619138542
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Entity Type | Individual
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Provider Name | SANDRA EDMOND THOMASIAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 8700 BEVERLY BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90048-1865
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Country | US
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Telephone | 310-423-8600
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Fax | 310-967-1800
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Provider Business Mailing Address
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Address Line | P.O. BOX 51258
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City | LOS ANGELES
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State | CA
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Zip | 90051-5558
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Country | US
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Telephone | 310-423-8600
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Fax | 310-967-1800
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A115451
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License Number State | CA
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