Healthcare Provider Details

I. General information

NPI: 1104709468
Provider Name (Legal Business Name): HAROLD LEONEL GIRON FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 CAMFIELD AVE
COMMERCE CA
90040-1574
US

IV. Provider business mailing address

10998 JACKSON AVE
LYNWOOD CA
90262-2324
US

V. Phone/Fax

Practice location:
  • Phone: 323-725-8751
  • Fax:
Mailing address:
  • Phone: 702-480-2582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95036221
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: