Provider Demographics
NPI:1538529177
Name:SUNSET WALK-IN HEALTHCARE AND OCCUPATIONAL MEDICINE CLINIC, PC
Entity type:Organization
Organization Name:SUNSET WALK-IN HEALTHCARE AND OCCUPATIONAL MEDICINE CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE
Authorized Official - Prefix:
Authorized Official - First Name:ZOE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-273-1155
Mailing Address - Street 1:9201 W SUNSET BLVD
Mailing Address - Street 2:M155
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-3701
Mailing Address - Country:US
Mailing Address - Phone:310-273-1155
Mailing Address - Fax:
Practice Address - Street 1:9201 W SUNSET BLVD
Practice Address - Street 2:M155
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-3701
Practice Address - Country:US
Practice Address - Phone:310-273-1155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG66088261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGN428AMedicare PIN