Healthcare Provider Details

I. General information

NPI: 1376071472
Provider Name (Legal Business Name): CHARMAINE BADE ARNAUD NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2017
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 N ROBERTSON BLVD
BEVERLY HILLS CA
90211-2103
US

IV. Provider business mailing address

3019 OCEAN PARK BLVD # 178
SANTA MONICA CA
90405-3004
US

V. Phone/Fax

Practice location:
  • Phone: 310-295-7925
  • Fax:
Mailing address:
  • Phone: 818-621-5130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95006391
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95006391
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: