Healthcare Provider Details

I. General information

NPI: 1487619763
Provider Name (Legal Business Name): EMILY HELEN CALDWELL N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 12/08/2021
Certification Date: 12/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 WILSHIRE BLVD SUITE 703
LOS ANGELES CA
90017-4807
US

IV. Provider business mailing address

1245 WILSHIRE BLVD STE 703
LOS ANGELES CA
90017-4807
US

V. Phone/Fax

Practice location:
  • Phone: 213-977-0419
  • Fax: 213-250-9416
Mailing address:
  • Phone: 213-977-7422
  • Fax: 213-250-8945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP13454
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: