MEDICARE: MS. ANNE P TRAYNOR NP

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
1	363LF0000X	Family Nurse Practitioner	422306	CA

General Provider Information

NPI Number	:	1457565798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNE P TRAYNOR NP

Provider Business Mailing Address
First Line	:	2201 PARK DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-1921
Country	:	US
Telephone Number	:	323-854-0750
Fax Number	:	310-423-9595

Provider Business Practice Location Address
First Line	:	6500 WILSHIRE BLVD
Second Line	:	SUITE 1000
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-4920
Country	:	US
Telephone Number	:	310-423-9540
Fax Number	:	310-423-9595

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	07/08/2007

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