Healthcare Provider Details

I. General information

NPI: 1033797071
Provider Name (Legal Business Name): NAMI OSTERWALD MSN, RN, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD
LOS ANGELES CA
90048
US

IV. Provider business mailing address

400 E LAS PALMAS DR
FULLERTON CA
92835-1614
US

V. Phone/Fax

Practice location:
  • Phone: 310-855-6863
  • Fax:
Mailing address:
  • Phone: 916-601-5691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95017050
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number95108439
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: