Individual
MS. BASAK JULIA KANLILAR-RUIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
200 MEDICAL PLAZA SUITE 365A, LOS ANGELES, CA 90095-3026
(310) 825-1597
(310) 206-0007
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-8707
(310) 301-8751
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
656953
CA
363L00000X
Nurse Practitioner
95007489
CA
363LA2100X
Acute Care Nurse Practitioner
NP95007489
CA
Other
Enumeration date
11/15/2017
Last updated
08/29/2022
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