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General NPI Number Information
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NPI Number | 1942821665
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Entity Type | Individual
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Provider Name | MS. ANN OLUFUNKE CARTER
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Gender | Female
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Dates
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Enumeration Date | 05/05/2020
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Last Update Date | 05/05/2020
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Provider Practice Location Address
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Address Line | 450 BAUCHET ST
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City | LOS ANGELES
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State | CA
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Zip | 90012-2907
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Country | US
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Telephone | 213-893-5504
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Fax |
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Provider Business Mailing Address
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Address Line | 19923 SCOBEY AVE
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City | CARSON
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State | CA
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Zip | 90746-3052
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Country | US
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Telephone | 310-613-8685
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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 | NPF95014165
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License Number State | CA
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