MRS. ILINA BERON


Address: 1059 S Holt Ave, Los Angeles, CA 90035-2009
Phone: 3106575678

MRS. ILINA BERON (NPI# 1417942616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417942616
Entity Type Individual
Full Name MRS. ILINA BERON
Credential NP
Practice Address 1059 S Holt Ave
Los Angeles
CA 90035-2009
Practice Telephone 3106575678
Practice Fax Number 3106525369
Mailing Telephone 3106575678
Mailing Fax Number 3106525369
Enumeration Date 2005-09-13
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
X 363LF0000X Nurse Practitioner
Specialization: Family
456661 CA Physician Assistants & Advanced Practice Nursing Providers
X 363LW0102X Nurse Practitioner
Specialization: Women's Health
456661 CA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1059 S HOLT AVE
City LOS ANGELES
State CA
Zip Code 90035-2009

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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Competitor

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City LOS ANGELES
Zip Code 90035

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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