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General NPI Number Information
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NPI Number | 1942489703
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Entity Type | Individual
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Provider Name | NHI AI NGO FNP
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Gender | Female
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Dates
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Enumeration Date | 10/29/2007
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Last Update Date | 10/29/2007
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Provider Practice Location Address
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Address Line | 900 N LAKE AVE
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City | PASADENA
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State | CA
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Zip | 91104-4563
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Country | US
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Telephone | 626-794-4714
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Fax |
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Provider Business Mailing Address
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Address Line | 216 E NEWMARK AVE APT B
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City | MONTEREY PARK
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State | CA
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Zip | 91755-2956
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Country | US
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Telephone | 626-572-4420
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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 | 16523
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License Number State | CA
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