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NPI Code Detail

MEDICARE: NINA A GARDNER

MEDICARE:   NINA A GARDNER
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1700478054
Entity Type Code : Individual
Provider Name (Legal Business Name) : NINA A GARDNER
Provider Business Mailing Address
First Line : 691 E WASHINGTON BLVD
Second Line :
City : PASADENA
State : CA
Zip : 91104-5003
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 691 E WASHINGTON BLVD
Second Line :
City : PASADENA
State : CA
Zip : 91104-5003
Country : US
Telephone Number : 626-234-9732
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2021
Last Update Date : 02/08/2021

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Directions to “ NINA A GARDNER ” Practice Location

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