MEDICARE: ERIC N NGUGI FNP-BC

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	363L00000X	Nurse Practitioner	AP61420994	WA
2	363L00000X	Nurse Practitioner	95024190	CA

General Provider Information

NPI Number	:	1467124107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC N NGUGI FNP-BC

Provider Business Mailing Address
First Line	:	2530 W EMPIRE AVE
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91504-5004
Country	:	US
Telephone Number	:	816-258-0038
Fax Number	:

Provider Business Practice Location Address
First Line	:	4082 WHITTIER BLVD STE 102
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90023-2559
Country	:	US
Telephone Number	:	816-258-0038
Fax Number	:

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

Provider Enumeration Date	:	10/01/2021
Last Update Date	:	08/20/2025

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Directions to “ ERIC N NGUGI FNP-BC” Practice Location

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