Provider Demographics
NPI:1053578112
Name:TSUNG, GABRIELE EMERITA BRUNHART (MSN, NP, CNS)
Entity type:Individual
Prefix:
First Name:GABRIELE
Middle Name:EMERITA BRUNHART
Last Name:TSUNG
Suffix:
Gender:F
Credentials:MSN, NP, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 WESTWOOD PLZ
Mailing Address - Street 2:SUITE 1-230 RNRC
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-8353
Mailing Address - Country:US
Mailing Address - Phone:310-825-5321
Mailing Address - Fax:
Practice Address - Street 1:710 WESTWOOD PLZ
Practice Address - Street 2:SUITE 1-230 RNRC
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-8353
Practice Address - Country:US
Practice Address - Phone:310-825-5321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA515827363LA2200X, 364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health