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NPI Code Detail

MEDICARE: END OF SHIFT MANAGEMENT GROUP INC

MEDICARE: END OF SHIFT MANAGEMENT GROUP INC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1497618128
Entity Type Code : Organization
Provider Name (Legal Business Name) : END OF SHIFT MANAGEMENT GROUP INC
Provider Business Mailing Address
First Line : 5603 CARFAX AVE
Second Line :
City : LAKEWOOD
State : CA
Zip : 90713-1253
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5603 CARFAX AVE
Second Line :
City : LAKEWOOD
State : CA
Zip : 90713-1253
Country : US
Telephone Number : 562-378-3798
Fax Number :
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : MARK ANWULI AWANYAI JR.
Credential :
Telephone Number : 562-378-3798
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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Directions to “END OF SHIFT MANAGEMENT GROUP INC ” Practice Location

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