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General NPI Number Information
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NPI Number | 1700444239
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Entity Type | Organization
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Legal Business Name | ELISABETH FINNERTY, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/30/2019
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Last Update Date | 05/30/2019
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Provider Practice Location Address
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Address Line | 2815 PICO BLVD
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City | SANTA MONICA
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State | CA
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Zip | 90405-1919
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Country | US
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Telephone | 310-314-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 2815 PICO BLVD
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City | SANTA MONICA
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State | CA
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Zip | 90405-1919
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Country | US
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Telephone | 310-314-2111
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Fax |
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Authorized Official
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Title or Position | PRESIDENT / FOUNDER
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Name | ELISABETH FINNERTY
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Credential |
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Telephone | 310-625-6226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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