Healthcare Provider Details

I. General information

NPI: 1578458295
Provider Name (Legal Business Name): AMANPREET KAUR FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 S CENTRAL AVE
LOS ANGELES CA
90011-3629
US

IV. Provider business mailing address

4425 S CENTRAL AVE
LOS ANGELES CA
90011-3629
US

V. Phone/Fax

Practice location:
  • Phone: 323-908-4200
  • Fax: 323-432-4877
Mailing address:
  • Phone: 323-908-4200
  • Fax: 323-432-4877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNPF95034326
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: