Provider Demographics
NPI:1255382826
Name:FRUTKIN, DEBORAH J (CRNA)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:J
Last Name:FRUTKIN
Suffix:
Gender:F
Credentials:CRNA
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Other - First Name:
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Mailing Address - Street 1:11301 WILSHIRE BLVD
Mailing Address - Street 2:BUILDING 500
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90073-1003
Mailing Address - Country:US
Mailing Address - Phone:310-268-3221
Mailing Address - Fax:310-268-3052
Practice Address - Street 1:450 N ROXBURY DR
Practice Address - Street 2:SUITE 600
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4232
Practice Address - Country:US
Practice Address - Phone:310-651-2280
Practice Address - Fax:310-651-2260
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA35033367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered