| Doctor Name: | MS. MARY ELIZABETH ROBERTS |
| NPI Number: | 1013253871 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | 22239 |
| Business Practice Address: | 8700 Beverly Blvd Room Scct2503 West Hollywood, CA - 900481804 |
| Business Phone Number: | 3104236706 |
| Business Fax Number: | 3104230397 |
| Mailing Address: | 8700 Beverly Blvd, Room Scct2503 WEST HOLLYWOOD |
| State: | CA |
| Postal Code: | 900481804 |
| Phone Number: | 3104236706 |
| Fax Number: | 3104230397 |
| NPI Enumeration Date: | 12/26/2012 |
| NPI Last Update Date: | 12/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | 22239 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |