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NPI Code Detail

MEDICARE: CARMEN JEAN ASESOR

MEDICARE: CARMEN JEAN ASESOR
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 PractitionerNP95007881CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NP95007881OTHERCABOARD OF REGISTERED NURSING

General Provider Information

NPI Number : 1770097909
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMEN JEAN ASESOR
Provider Business Mailing Address
First Line : 2874 E TYLER ST
Second Line :
City : LONG BEACH
State : CA
Zip : 90810-1422
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3637 MOTOR AVE STE 360
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-4883
Country : US
Telephone Number : 310-841-0038
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2017
Last Update Date : 11/27/2017

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Directions to “ CARMEN JEAN ASESOR ” Practice Location

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