Provider Demographics
NPI:1134491335
Name:DR. RUTH SOROTZKIN
Entity Type:Organization
Organization Name:DR. RUTH SOROTZKIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:SOROTZKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-566-6330
Mailing Address - Street 1:2811 WILSHIRE BLVD STE 800
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-4808
Mailing Address - Country:US
Mailing Address - Phone:310-566-6330
Mailing Address - Fax:310-566-6320
Practice Address - Street 1:2811 WILSHIRE BLVD STE 800
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-4808
Practice Address - Country:US
Practice Address - Phone:310-566-6330
Practice Address - Fax:310-566-6320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care