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Organization
WILSHIRE MULTI-SPECIALTY CLINIC
Active
Organization
WILSHIRE MULTI-SPECIALTY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KUSUM RUDRAPPA MD (MEDICAL DIRECTOR)
(213) 388-3712
Entity
Organization
Contact information
Practice address
3540 WILSHIRE BLVD, STE: 1028, LOS ANGELES, CA 90010-2307
(213) 388-3712
(213) 388-0734
Mailing address
3540 WILSHIRE BLVD, STE: 1028, LOS ANGELES, CA 90010-2307
(213) 388-3712
(213) 388-0734
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
G87522
CA
207QS1201X
Sleep Medicine (Family Medicine) Physician
—
NULL
207QS1201X
Sleep Medicine (Family Medicine) Physician
—
—
207RS0010X
Sports Medicine (Internal Medicine) Physician
A37070
CA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
A54260
CA
207Y00000X
Otolaryngology Physician
G36302
CA
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
PSY12331
CA
208D00000X
General Practice Physician
Primary
A37070
CA
Other
Enumeration date
09/16/2009
Last updated
09/16/2009
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