Individual
WEATHERALL BORDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
757 WESTWOOD PLZ STE 3325, LOS ANGELES, CA 90095-8358
(310) 794-4494
(310) 267-3899
Mailing address
5767 W CENTURY BLVD SUITE 400, LOS ANGELES, CA 90095-5631
(310) 301-8707
(310) 301-8751
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95242181
CA
367500000X
Certified Registered Nurse Anesthetist
95001577
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN673456
PA
Other
Enumeration date
03/25/2021
Last updated
11/06/2023
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