Magnolia Nursing Professional Corporation
Nurse Practitioner, Family in Los Angeles, CA. Organization (NPI-2).
NPI number1629720883
StatusActive
Last updated in NPPESNov 8, 2022
Details
- NPI
- 1629720883
- Entity type
- Organization (NPI-2)
- Legal business name
- Magnolia Nursing Professional Corporation
- Organization subpart
- No
- Enumeration date
- Jan 19, 2022
- Certification date
- Nov 8, 2022
- Last updated
- Nov 8, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
Practice location
3435 Wilshire Blvd Ste 2780Los Angeles, CA 90010-1901
Phone 714-785-3639
Mailing address
8453 Penny DrRiverside, CA 92503-1488
Phone 714-785-3639
Authorized official
Christian Reyes
President
7147853639
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