MEDICARE: HOPE PROFESSIONAL MEDICAL GROUP & NURSING CORPORATION

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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1649127440
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE PROFESSIONAL MEDICAL GROUP & NURSING CORPORATION

Provider Business Mailing Address
First Line	:	1539 W 158TH ST UNIT 4
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90247-3813
Country	:	US
Telephone Number	:	310-848-8865
Fax Number	:

Provider Business Practice Location Address
First Line	:	1539 W 158TH ST UNIT 4
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90247-3813
Country	:	US
Telephone Number	:	310-848-8865
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE OWNER
Name	:	EDEN DABALUS
Credential	:
Telephone Number	:	310-848-8865

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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