Healthcare Provider Details

I. General information

NPI: 1922214402
Provider Name (Legal Business Name): MARGARET AVILA RN-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 04/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 E. 3RD STREET SUITE 810
LOS ANGELES CA
90013-1644
US

IV. Provider business mailing address

420 E 3RD ST SUITE 810
LOS ANGELES CA
90013-1644
US

V. Phone/Fax

Practice location:
  • Phone: 213-625-0717
  • Fax: 231-625-0770
Mailing address:
  • Phone: 213-625-0717
  • Fax: 213-625-0770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN 207786
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN 207786
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: