Provider Demographics
NPI:1871731067
Name:CEDAR SINAI MEDICAL CENTER
Entity type:Organization
Organization Name:CEDAR SINAI MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:OLIVER
Authorized Official - Middle Name:
Authorized Official - Last Name:SEVERIOS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:310-423-5895
Mailing Address - Street 1:1708 ESPLANADE APT 10
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-5326
Mailing Address - Country:US
Mailing Address - Phone:310-600-3049
Mailing Address - Fax:
Practice Address - Street 1:444 SOUTH SAN VINCENTE BLVD.
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-423-5895
Practice Address - Fax:310-423-9290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35355283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital