MEDICARE: ONYX IFEMEMBI

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	163WH1000X	Hospice Registered Nurse	95050212	CA

General Provider Information

NPI Number	:	1356847214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ONYX IFEMEMBI

Provider Business Mailing Address
First Line	:	2010 W AVENUE K # 510
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93536-5229
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5503 CAHUENGA BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-2941
Country	:	US
Telephone Number	:	661-547-2408
Fax Number	:

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

Provider Enumeration Date	:	03/31/2018
Last Update Date	:	03/31/2018

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