Cedars-Sinai Medical Center

Payment Gateway

Note: * indicates required fields.

Fee Type

Credentialing Process

Reappointment

Initial Applicant

Practitioner Type

Fee Type

Specialty

Amount Due

Practitioner

MD ID #/AHP ID # (if known)

First Name

Middle Name

Last Name

Address

Address (cont.)

City

State

Zip

Phone

Email

Billing Info

Same as practitioner?

First Name

Last Name

Address

Address (cont.)

City

State

Zip