MEDICARE: MERILYN SANTOS ADRINEDA FNP

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	RN-531081 NP14080	CA

General Provider Information

NPI Number	:	1851359129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERILYN SANTOS ADRINEDA FNP

Provider Business Mailing Address
First Line	:	407 E CLARION DR
Second Line	:
City	:	CARSON
State	:	CA
Zip	:	90745-1318
Country	:	US
Telephone Number	:	310-347-8665
Fax Number	:

Provider Business Practice Location Address
First Line	:	1141 W REDONDO BEACH BLVD
Second Line	:	SUITE 404
City	:	GARDENA
State	:	CA
Zip	:	90247-3586
Country	:	US
Telephone Number	:	310-851-9260
Fax Number	:	310-851-9261

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	07/08/2007

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