Healthcare Provider Details

I. General information

NPI: 1497083141
Provider Name (Legal Business Name): MARY E HULL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2009
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8767 WILSHIRE BLVD FL 3
BEVERLY HILLS CA
90211-2714
US

IV. Provider business mailing address

4140 W 190TH ST
TORRANCE CA
90504-5513
US

V. Phone/Fax

Practice location:
  • Phone: 424-315-0302
  • Fax: 424-315-0303
Mailing address:
  • Phone: 424-315-0302
  • Fax: 424-315-0303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18248
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: