Provider Demographics
NPI:1811195852
Name:NAKASUJI, CINDY C (NP)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:C
Last Name:NAKASUJI
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 1:1 LMU DR # MS 8455
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-2650
Mailing Address - Country:US
Mailing Address - Phone:310-338-5275
Mailing Address - Fax:
Practice Address - Street 1:1 LMU DR # MS 8455
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-2650
Practice Address - Country:US
Practice Address - Phone:310-338-5275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17004363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics