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General NPI Number Information
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NPI Number | 1760172696
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Entity Type | Individual
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Provider Name | ELIZABETH MARIA ELENA HERNANDEZ-BALL NP
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Gender | Female
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Dates
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Enumeration Date | 05/12/2023
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 5001 PACIFIC COAST HWY
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City | TORRANCE
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State | CA
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Zip | 90505-5441
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Country | US
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Telephone | 310-318-4127
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Fax |
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Provider Business Mailing Address
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Address Line | 625 ESPLANADE UNIT 36
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City | REDONDO BEACH
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State | CA
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Zip | 90277-4147
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Country | US
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Telephone | 310-318-4127
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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 | 95024994
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License Number State | CA
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