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General NPI Number Information
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NPI Number | 1427720234
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Entity Type | Individual
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Provider Name | GLORIA OTIENO-OBILO NP
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Gender | Female
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Dates
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Enumeration Date | 09/30/2021
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 5611 E VERNON ST
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City | LONG BEACH
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State | CA
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Zip | 90815-2048
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Country | US
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Telephone | 253-561-5294
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Fax |
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Provider Business Mailing Address
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Address Line | 300 CONTINENTAL BLVD STE 560
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City | EL SEGUNDO
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State | CA
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Zip | 90245-5030
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Country | US
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Telephone | 310-658-3775
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 95018136
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License Number State | CA
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Legacy Identifiers
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Identifier #1
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Identifier Code | 95018136
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Identifier Type | OTHER
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Identifier State | CA
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Identifier Issuer | NP LICENCE
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 95018136
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Identifier Type | OTHER
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Identifier State | CA
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Identifier Issuer | NP LICENCE
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