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NPI Code Detail

MEDICARE: EDDIE YEE DESCALLAR NP-C

MEDICARE: EDDIE YEE DESCALLAR NP-C
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
1363LF0000XFamily Nurse Practitioner20130CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629386230
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDDIE YEE DESCALLAR NP-C
Provider Business Mailing Address
First Line : 9547 VIA SALERNO
Second Line :
City : BURBANK
State : CA
Zip : 91504-1225
Country : US
Telephone Number : 818-489-2132
Fax Number : 818-252-1330
Provider Business Practice Location Address
First Line : 1800 WILSHIRE BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-3602
Country : US
Telephone Number : 213-484-9934
Fax Number : 213-484-9939
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2010
Last Update Date : 12/28/2012

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