Provider Demographics
NPI:1235179037
Name:PLAZA-TOWERS OB/GYN
Entity Type:Organization
Organization Name:PLAZA-TOWERS OB/GYN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NATHALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUI
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:310-424-3434
Mailing Address - Street 1:2001 SANTA MONICA BLVD. #468W
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404
Mailing Address - Country:US
Mailing Address - Phone:310-255-0990
Mailing Address - Fax:310-255-0996
Practice Address - Street 1:2001 SANTA MONICA BLVD. #468W
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404
Practice Address - Country:US
Practice Address - Phone:310-255-0990
Practice Address - Fax:310-255-0996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW14051Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER