Healthcare Provider Details

I. General information

NPI: 1053065268
Provider Name (Legal Business Name): DARRYL HANA MANALANG ESGUERRA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2022
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 E 120TH ST
LOS ANGELES CA
90059-3026
US

IV. Provider business mailing address

20402 PIONEER BLVD
LAKEWOOD CA
90715-1345
US

V. Phone/Fax

Practice location:
  • Phone: 424-338-1000
  • Fax:
Mailing address:
  • Phone: 562-441-8748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95018789
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: