Healthcare Provider Details

I. General information

NPI: 1780087163
Provider Name (Legal Business Name): WENDY HILL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2014
Last Update Date: 09/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 S. SAN VINCENTE BLVD SUITE A6100
LOS ANGELES CA
90048
US

IV. Provider business mailing address

127 S. SAN VINCENTE BLVD
LOS ANGELES CA
90048
US

V. Phone/Fax

Practice location:
  • Phone: 310-248-8388
  • Fax:
Mailing address:
  • Phone: 310-248-8388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number396912
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: