Provider Demographics
NPI:1255779278
Name:KNUDSEN, BEATRICE S (MD, PHD)
Entity type:Individual
Prefix:MS
First Name:BEATRICE
Middle Name:S
Last Name:KNUDSEN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:116 N ROBERTSON BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-3103
Mailing Address - Country:US
Mailing Address - Phone:310-248-8687
Mailing Address - Fax:310-248-6233
Practice Address - Street 1:116 N ROBERTSON BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3103
Practice Address - Country:US
Practice Address - Phone:310-248-8687
Practice Address - Fax:310-248-6233
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG89286207ZP0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic Pathology