Individual provider · NPI-1

Fendee Madayag Anselmo

Registered Nurse, General Practice · Los Angeles, CA

NPI number1336797125
StatusActive
Last updated in NPPESAug 27, 2019

Details

NPI
1336797125
Entity type
Individual (NPI-1)
Name
Fendee Madayag Anselmo
Sex
Female
Sole proprietor
No
Enumeration date
Aug 27, 2019
Last updated
Aug 27, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WG0000X Registered Nurse, General Practice95142090CAYes

Practice location

11845 W Olympic Blvd Ste 900w
Los Angeles, CA 90064-5086

Phone 213-296-3783

Mailing address

8097 Calendula Dr
Buena Park, CA 90620-2005

Phone 714-348-4783

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