=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649814765
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MANETTE SINKUS NURSING APC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/31/2019
-----------------------------------------------------
Last Update Date | 10/31/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 21250 HAWTHORNE BLVD STE 435
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-326-2102
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1700 2ND ST
-----------------------------------------------------
City | MANHATTAN BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90266-7012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-779-8669
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | REGISTERED NURSE FIRST ASSISTANT
-----------------------------------------------------
Name | MANETTE SINKUS
-----------------------------------------------------
Credential | RN, RNFA
-----------------------------------------------------
Telephone | 808-779-8669
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------