Provider Demographics
NPI:1497195739
Name:CEDARS-SINAI MEDICAL CARE FOUNDATION
Entity Type:Organization
Organization Name:CEDARS-SINAI MEDICAL CARE FOUNDATION
Other - Org Name:CEDAR-SINAI HEALTH SYSTEM - MEDICAL NETWORK SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MPAP
Authorized Official - Phone:310-385-3550
Mailing Address - Street 1:200 N ROBERTSON BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1769
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8501 WILSHIRE BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3150
Practice Address - Country:US
Practice Address - Phone:310-248-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA23057363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty