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NPI Code Detail

MEDICARE: RENUKA ABRAHAM NP

MEDICARE: RENUKA ABRAHAM NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerNP95029644CA

General Provider Information

NPI Number : 1013750926
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENUKA ABRAHAM NP
Provider Business Mailing Address
First Line : 18607 VENTURA BLVD STE 102
Second Line :
City : TARZANA
State : CA
Zip : 91356-6804
Country : US
Telephone Number : 818-600-1472
Fax Number :
Provider Business Practice Location Address
First Line : 18607 VENTURA BLVD STE 102
Second Line :
City : TARZANA
State : CA
Zip : 91356-6804
Country : US
Telephone Number : 818-600-1472
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2024
Last Update Date : 06/18/2024

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Directions to “ RENUKA ABRAHAM NP” Practice Location

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