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General NPI Number Information
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NPI Number | 1376898494
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Entity Type | Individual
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Provider Name | EMILY LANCASTER TAJUDEEN ANP-C
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Gender | Female
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Dates
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Enumeration Date | 07/14/2012
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Last Update Date | 03/28/2017
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Provider Practice Location Address
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Address Line | 6043 HOLLYWOOD BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90028-5411
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Country | US
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Telephone | 323-337-1720
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Fax | 323-337-1784
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Provider Business Mailing Address
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Address Line | 530 W CORNELIA AVE 1N
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City | CHICAGO
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State | IL
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Zip | 60657-2758
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Country | US
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Telephone | 310-625-0319
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 22019
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License Number State | CA
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