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General NPI Number Information
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NPI Number | 1932016631
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Entity Type | Organization
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Legal Business Name | EOS NURSING
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Dates
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Enumeration Date | 08/26/2026
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 5603 CARFAX AVE
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City | LAKEWOOD
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State | CA
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Zip | 90713-1253
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Country | US
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Telephone | 562-378-3798
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Fax | 562-512-4871
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Provider Business Mailing Address
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Address Line | 5603 CARFAX AVE
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City | LAKEWOOD
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State | CA
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Zip | 90713-1253
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Country | US
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Telephone | 562-378-3798
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Fax | 562-512-4871
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARK ANWULI AWANYAI JR.
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Credential | PMHNP-BC
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Telephone | 562-378-3798
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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