MEDICARE: NORYDEL TUIZA LAURETA RN

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
1	163W00000X	Registered Nurse	95441613	CA

General Provider Information

NPI Number	:	1235089335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORYDEL TUIZA LAURETA RN

Provider Business Mailing Address
First Line	:	321 N HOBART BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-1803
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	321 N HOBART BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-1803
Country	:	US
Telephone Number	:	323-653-1990
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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