Individual
DR. JOANNE K. L. RUTGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8700 BEVERLY BLVD, DEPT OF PATHOLOGY, WEST HOLLYWOOD, CA 90048-1804
(310) 423-6623
(310) 423-0122
Mailing address
8700 BEVERLY BLVD, DEPT. OF PATHOLOGY, WEST HOLLYWOOD, CA 90048-1804
(310) 423-6623
(310) 423-0122
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
G60455
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G60455
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G604550
—
CA
Enumeration date
04/05/2006
Last updated
05/16/2014
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