Provider Demographics
NPI:1467748145
Name:RUNIA, BARBARA (RN , CWON)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:RUNIA
Suffix:
Gender:F
Credentials:RN , CWON
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 WESTWOOD BLVD SUITE # 2D
Mailing Address - Street 2:C/O BABAK ROOZROKH MD
Mailing Address - City:LA
Mailing Address - State:CA
Mailing Address - Zip Code:90025
Mailing Address - Country:US
Mailing Address - Phone:310-230-7400
Mailing Address - Fax:
Practice Address - Street 1:1700 WESTWOOD BLVD
Practice Address - Street 2:SUITE # 2D
Practice Address - City:LA
Practice Address - State:CA
Practice Address - Zip Code:90025
Practice Address - Country:US
Practice Address - Phone:310-230-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA272695163W00000X
CA2002211227163WW0000X, 163WX1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163W00000XNursing Service ProvidersRegistered Nurse
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2002211227OtherCWON CERTIFICATE
CA272695OtherCALIFORNIA LICENCE