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NPI Code Detail

MEDICARE: DENIS WADZANI FNP-C, MPH

MEDICARE: DENIS WADZANI FNP-C, MPH
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
1163W00000XRegistered Nurse95061349CA
2163WC1500XCommunity Health Registered Nurse550753CA
3363L00000XNurse Practitioner95006189CA
4363LP2300XPrimary Care Nurse Practitioner95006189CA
5363LF0000XFamily Nurse Practitioner95006189CA

General Provider Information

NPI Number : 1386177129
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENIS WADZANI FNP-C, MPH
Provider Business Mailing Address
First Line : 100 CORPORATE POINTE STE 270
Second Line :
City : LOS ANGELES
State : CA
Zip : 90230-8735
Country : US
Telephone Number : 424-266-7472
Fax Number :
Provider Business Practice Location Address
First Line : 5901 GREEN VALLEY CIR STE 405
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-6971
Country : US
Telephone Number : 424-266-7474
Fax Number : 310-596-8268
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2017
Last Update Date : 05/19/2025

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