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NPI Code Detail

MEDICARE: ADRIANA MATEOS

MEDICARE: ADRIANA MATEOS
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 Nurse839982CA
2171M00000XCase Manager/Care Coordinator839982CA

General Provider Information

NPI Number : 1760804819
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADRIANA MATEOS
Provider Business Mailing Address
First Line : 3820 MARTIN LUTHER KING JR BLVD
Second Line :
City : LYNWOOD
State : CA
Zip : 90262-3625
Country : US
Telephone Number : 310-639-0415
Fax Number :
Provider Business Practice Location Address
First Line : 1776 E CENTURY BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90002-3050
Country : US
Telephone Number : 323-374-6848
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2014
Last Update Date : 05/31/2023

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Directions to “ ADRIANA MATEOS ” Practice Location

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