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General NPI Number Information
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NPI Number | 1508476292
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Entity Type | Individual
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Provider Name | NAHIROBI JASMIN MADRID ANTUNEZ FNP
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Gender | Female
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Dates
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Enumeration Date | 08/06/2020
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Last Update Date | 08/06/2020
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Provider Practice Location Address
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Address Line | 450 BAUCHET ST
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City | LOS ANGELES
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State | CA
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Zip | 90012-2907
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Country | US
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Telephone | 213-893-5542
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Fax |
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Provider Business Mailing Address
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Address Line | 16011 1/2 PIONEER BLVD
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City | NORWALK
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State | CA
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Zip | 90650-7181
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Country | US
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Telephone | 213-309-7800
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95014371
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License Number State | CA
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