MEDICARE: ASSEFA EJIGU MEKONNEN PMHNP

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
1	363LF0000X	Family Nurse Practitioner	95001041	CA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95001041	CA
3	163WP0808X	Psychiatric/Mental Health Registered Nurse	95001041	CA

General Provider Information

NPI Number	:	1942605126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASSEFA EJIGU MEKONNEN PMHNP

Provider Business Mailing Address
First Line	:	PO BOX 4570
Second Line	:
City	:	PALOS VERDES PENINSULA
State	:	CA
Zip	:	90274-9607
Country	:	US
Telephone Number	:	424-400-7748
Fax Number	:	424-400-7749

Provider Business Practice Location Address
First Line	:	1711 W TEMPLE ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-7329
Country	:	US
Telephone Number	:	213-989-6100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2014
Last Update Date	:	12/01/2023

Similar Medicare Providers

1396603601 — AZEL GIZELLE REYNOZO NP
Practice Location Address:

1711 W TEMPLE ST
LOS ANGELES, CA
90026-7329

Practice Phone: 213-989-6100
Practice Fax: 213-484-3552

1770736456 — UROGYNECOLOGY ASSOCIATES, A MEDICAL CORPORATION
Practice Location Address:

1711 W TEMPLE ST
LOS ANGELES, CA
90026-7329

Practice Phone: 657-888-3008
Practice Fax: 657-888-9181

1871943761 — ZUMAYA MEDICAL GROUP, INC.
Practice Location Address:

1711 W TEMPLE ST STE 1059
LOS ANGELES, CA
90026-7329

Practice Phone: 626-899-4573
Practice Fax: 626-899-4575

1982260899 — ANTHONY SAMAAN DPM
Practice Location Address:

1711 W TEMPLE ST
LOS ANGELES, CA
90026-7329

Practice Phone: 213-989-6100
Practice Fax:

1689225427 — MR. ROBERT WAYNE BAKER N.P.
Practice Location Address:

1711 W TEMPLE ST STE 1082
LOS ANGELES, CA
90026-7329

Practice Phone: 818-395-3060
Practice Fax:

1750995916 — YERANUI STEPANYAN NP ADVANCE PRACTICE NURSING APC
Practice Location Address:

1711 W TEMPLE ST FL 1
LOS ANGELES, CA
90026-7329

Practice Phone: 213-989-6100
Practice Fax:

Directions to “ ASSEFA EJIGU MEKONNEN PMHNP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.