Healthcare Provider Details

I. General information

NPI: 1932516747
Provider Name (Legal Business Name): NANCY BEYDA LM/CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2014
Last Update Date: 07/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1949 N WILTON PL
LOS ANGELES CA
90068-3626
US

IV. Provider business mailing address

1949 N WILTON PL
LOS ANGELES CA
90068-3626
US

V. Phone/Fax

Practice location:
  • Phone: 323-646-4362
  • Fax: 323-467-6636
Mailing address:
  • Phone: 323-646-4362
  • Fax: 323-467-6636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number404
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: