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General NPI Number Information
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NPI Number | 1396489639
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Entity Type | Individual
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Provider Name | FATMA HACIOGLU FNP
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Gender | Female
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Dates
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Enumeration Date | 04/22/2022
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | ST LUKE MEDICAL CLINIC 5912 SANTA MONICA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90038
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Country | US
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Telephone | 323-461-3888
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Fax | 323-461-3250
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Provider Business Mailing Address
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Address Line | ST LUKE MEDICAL CLINIC 5912 SANTA MONICA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90038
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Country | US
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Telephone | 323-461-3888
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Fax | 323-461-3250
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP95020555
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License Number State | CA
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