=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942269725
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CEDARS-SINAI MARINA HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/21/2006
-----------------------------------------------------
Last Update Date | 01/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4650 LINCOLN BLVD
-----------------------------------------------------
City | MARINA DEL REY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90292-6306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-448-5261
-----------------------------------------------------
Fax | 310-574-7854
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4650 LINCOLN BLVD
-----------------------------------------------------
City | MARINA DEL REY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90292-6306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-448-5261
-----------------------------------------------------
Fax | 310-574-7854
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP, FINANCE AND CRO
-----------------------------------------------------
Name | LISA MAQUEIRA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 310-385-3273
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number | 930000096
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------