MEDICARE: MS. ERIKA CAROL TUNICK M.S.W.

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1710064993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ERIKA CAROL TUNICK M.S.W.

Provider Business Mailing Address
First Line	:	4470 ELENDA ST
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-4134
Country	:	US
Telephone Number	:	310-838-8048
Fax Number	:

Provider Business Practice Location Address
First Line	:	11301 WILSHIRE BLVD
Second Line	:	BLDG. 500, RM. 6251
City	:	LOS ANGELES
State	:	CA
Zip	:	90073-1003
Country	:	US
Telephone Number	:	310-478-3711
Fax Number	:

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

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