Provider Demographics
NPI:1477866879
Name:ISRAEL, LOVELY (NP)
Entity Type:Individual
Prefix:
First Name:LOVELY
Middle Name:
Last Name:ISRAEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 WILSHIRE BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-4751
Mailing Address - Country:US
Mailing Address - Phone:310-566-0858
Mailing Address - Fax:
Practice Address - Street 1:2730 WILSHIRE BLVD STE 320
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-4751
Practice Address - Country:US
Practice Address - Phone:310-566-0858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16680363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology