Basic Information
| Provider Information | |||||||||
| NPI: | 1770811671 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SLIWOSKI | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | |||||||||
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| Credential: | BSN, PHN | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 605 W OLYMPIC BLVD STE 600 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900151475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2132369388 | ||||||||
| FaxNumber: | 2134897993 | ||||||||
| Practice Location | |||||||||
| Address1: | 605 W OLYMPIC BLVD STE 600 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900151475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2132369388 | ||||||||
| FaxNumber: | 2134897993 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2009 | ||||||||
| LastUpdateDate: | 04/26/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 95076812 | CA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.