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NPI Code Detail

MEDICARE: JOSEPHINE REYES CABUGNASON

MEDICARE:   JOSEPHINE REYES CABUGNASON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner23041CA

General Provider Information

NPI Number : 1336585819
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPHINE REYES CABUGNASON
Provider Business Mailing Address
First Line : 20941 CONRADI AVE
Second Line :
City : TORRANCE
State : CA
Zip : 90502-1712
Country : US
Telephone Number : 310-500-6254
Fax Number :
Provider Business Practice Location Address
First Line : 1959 KINGSDALE AVE
Second Line :
City : REDONDO BEACH
State : CA
Zip : 90278-3417
Country : US
Telephone Number : 310-214-1000
Fax Number : 310-214-8540
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2013
Last Update Date : 05/10/2013

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Directions to “ JOSEPHINE REYES CABUGNASON ” Practice Location

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