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NPI Code Detail

MEDICARE: CHRISTINA SOUTHERN REH M.D.

MEDICARE: CHRISTINA SOUTHERN REH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianA94219CA
22080P0205XPediatric Endocrinology PhysicianA94219CA

General Provider Information

NPI Number : 1255579371
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA SOUTHERN REH M.D.
Provider Business Mailing Address
First Line : 5767 W CENTURY BLVD STE 400
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-5631
Country : US
Telephone Number : 310-948-1646
Fax Number :
Provider Business Practice Location Address
First Line : 200 UCLA MEDICAL PLZ STE 265
Second Line :
City : LOS ANGELES
State : CA
Zip : 90095-3835
Country : US
Telephone Number : 310-825-0867
Fax Number : 310-794-5066
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2009
Last Update Date : 01/03/2023

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Directions to “ CHRISTINA SOUTHERN REH M.D.” Practice Location

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