MEDICARE: ADVANCED NURSING THERAPEUTICS 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
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1700516945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED NURSING THERAPEUTICS INC

Provider Business Mailing Address
First Line	:	22925 MULBERRY GLEN DR
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91354-2017
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13323 W WASHINGTON BLVD STE 202
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-5163
Country	:	US
Telephone Number	:	310-279-5010
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TERRANCE ITO
Credential	:	NP
Telephone Number	:	310-488-7304

Provider Enumeration Date	:	06/11/2022
Last Update Date	:	06/11/2022

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