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General NPI Number Information
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NPI Number | 1982239570
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Entity Type | Individual
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Provider Name | NWE NWE SOE MBBS PHD D(ABHI)
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Gender | Female
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Dates
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Enumeration Date | 03/04/2020
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 10833 LE CONTE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90095-1248
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Country | US
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Telephone | 310-206-0944
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Fax |
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Provider Business Mailing Address
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Address Line | 5767 W CENTURY BLVD STE 400
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City | LOS ANGELES
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State | CA
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Zip | 90045-5631
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Country | US
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Telephone | 310-301-6836
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Fax |
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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 | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | DI51072
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number | DI51072
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207ZC0006X
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Taxonomy Name | Clinical Pathology Physician
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License Number | MTR02004425
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License Number State | CA
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