Basic Information
Provider Information
NPI: 1861660482
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BOKEN
FirstName: EMILY
MiddleName: EVA
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5767 W CENTURY BLVD STE 400
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900455631
CountryCode: US
TelephoneNumber: 3103018707
FaxNumber: 1030187513
Practice Location
Address1: 757 WESTWOOD PLZ
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 90095
CountryCode: US
TelephoneNumber: 3108259111
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/16/2008
LastUpdateDate: 07/16/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X222558MAN Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000XA103273CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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