Provider Demographics
NPI:1194325084
Name:GOLUB, RIMMA R (NP)
Entity type:Individual
Prefix:MRS
First Name:RIMMA
Middle Name:R
Last Name:GOLUB
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:948 N. FAIRFAX AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046
Mailing Address - Country:US
Mailing Address - Phone:323-654-2020
Mailing Address - Fax:323-654-2828
Practice Address - Street 1:948 N. FAIRFAX AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046
Practice Address - Country:US
Practice Address - Phone:323-654-2020
Practice Address - Fax:323-654-2828
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95015460363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily