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NPI Code Detail

MEDICARE: ASHLEY MARIE BLUNDELL-SANDERS RN

MEDICARE: ASHLEY MARIE BLUNDELL-SANDERS 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
1163W00000XRegistered Nurse823718CA

General Provider Information

NPI Number : 1598120453
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY MARIE BLUNDELL-SANDERS RN
Provider Business Mailing Address
First Line : 601 W 19TH ST
Second Line :
City : COSTA MESA
State : CA
Zip : 92627-5060
Country : US
Telephone Number : 714-922-4100
Fax Number : 949-548-9051
Provider Business Practice Location Address
First Line : 601 W 19TH ST
Second Line :
City : COSTA MESA
State : CA
Zip : 92627-5060
Country : US
Telephone Number : 714-922-4100
Fax Number : 949-548-9051
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2015
Last Update Date : 12/19/2015

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