MEDICARE: RAND ALAN RUSHER RN

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	163WS0121X	Plastic Surgery Registered Nurse	455115	CA

General Provider Information

NPI Number	:	1932677796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAND ALAN RUSHER RN

Provider Business Mailing Address
First Line	:	9735 WILSHIRE BLVD PH
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-2104
Country	:	US
Telephone Number	:	310-275-7263
Fax Number	:

Provider Business Practice Location Address
First Line	:	9735 WILSHIRE BLVD PH
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-2104
Country	:	US
Telephone Number	:	310-275-7263
Fax Number	:

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

Provider Enumeration Date	:	11/08/2018
Last Update Date	:	11/08/2018

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