Healthcare Provider Details

I. General information

NPI: 1881169688
Provider Name (Legal Business Name): MARIA LEILANI APOSTOL DY NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIA LEILANI APOSTOL DY NP

II. Dates (important events)

Enumeration Date: 10/08/2018
Last Update Date: 10/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4505 SLAUSON AVE
MAYWOOD CA
90270-4942
US

IV. Provider business mailing address

3707 GARNET ST APT 206
TORRANCE CA
90503-3317
US

V. Phone/Fax

Practice location:
  • Phone: 323-771-0080
  • Fax:
Mailing address:
  • Phone: 818-384-6848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95010149
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: