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General NPI Number Information
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NPI Number | 1851976567
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Entity Type | Organization
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Legal Business Name | MEDEVAL TIME A NURSING CORPORATION
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Dates
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Enumeration Date | 03/15/2021
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 444 S FIGUEROA ST # 3111
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City | LOS ANGELES
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State | CA
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Zip | 90071-1613
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Country | US
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Telephone | 800-613-5386
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Fax | 702-252-0684
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Provider Business Mailing Address
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Address Line | 444 S FIGUEROA ST # 3111
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City | LOS ANGELES
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State | CA
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Zip | 90071-1613
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Country | US
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Telephone | 800-613-5386
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Fax | 702-252-0684
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Authorized Official
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Title or Position | OWNER
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Name | JASON CALLOWAY
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Credential | NP
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Telephone | 800-613-5386
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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 |
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License Number State |
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