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General NPI Number Information
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NPI Number | 1790555860
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Entity Type | Individual
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Provider Name | AUBREY MARIE RAZALAN ELIGIO FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/08/2024
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 1701 E CESAR E CHAVEZ AVE STE 128
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City | LOS ANGELES
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State | CA
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Zip | 90033-2483
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Country | US
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Telephone | 323-223-2338
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Fax | 323-225-2340
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Provider Business Mailing Address
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Address Line | 7155 CITRUS AVE UNIT 128
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City | FONTANA
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State | CA
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Zip | 92336-6002
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Country | US
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Telephone | 818-272-2984
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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 | 95025095
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License Number State | CA
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