Healthcare Provider Details

I. General information

NPI: 1487576211
Provider Name (Legal Business Name): GARIFRANCIS GIMENA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19959 ENADIA WAY
WINNETKA CA
91306-3637
US

IV. Provider business mailing address

19959 ENADIA WAY
WINNETKA CA
91306-3637
US

V. Phone/Fax

Practice location:
  • Phone: 213-447-2848
  • Fax:
Mailing address:
  • Phone: 213-447-2848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95316244
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: