FENDEE MADAYAG ANSELMO (NPI# 1336797125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336797125 |
Entity Type | Individual |
Full Name | FENDEE MADAYAG ANSELMO |
Practice Address |
11845 W Olympic Blvd Ste 900w Los Angeles CA 90064-5086 |
Mailing Address |
8097 Calendula Dr Buena Park CA 90620-2005 |
Practice Telephone | 2132963783 |
Mailing Telephone | 7143484783 |
Enumeration Date | 2019-08-27 |
Last Update Date | 2019-08-27 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 163WG0000X |
Registered Nurse Specialization: General Practice |
95142090 | CA | Nursing Service Providers |
Street Address |
11845 W OLYMPIC BLVD STE 900W |
City | LOS ANGELES |
State | CA |
Zip Code | 90064-5086 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255486072 | Robert K Kakehashi | Internal Medicine | 11845 W Olympic Blvd Ste 900w, Los Angeles, CA 90064-5086 | 2007-01-24 |
1285017277 | Dua Medical, Inc. | Internal Medicine | 11845 W Olympic Blvd Ste 900w, Los Angeles, CA 90064-5086 | 2015-07-08 |
1932441425 | Esther Souyon Park | Pediatrics | 11845 W Olympic Blvd Ste 900w, Los Angeles, CA 90064-5086 | 2013-03-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134727597 | Barbara K. Polland | Marriage & Family Therapist | 10533 Rountree Rd., Los Angeles, CA 90064 | 2020-10-16 |
1912542994 | Reproductive Medicine Associates of Socal Ambulatory Surgery Center | Clinic/Center | 11500 W Olympic Blvd, Ste# 150, Los Angeles, CA 90064 | 2019-11-13 |
1376022012 | Payersdirect, Inc. | Radiology | 11845 W Olympic Blvd Ste 1100w, Los Angeles, CA 90064 | 2018-08-13 |
1013404136 | Jeannie Wakamatsu | Dietitian, Registered | 10312 Almayo Ave., Suite 6, Los Angeles, CA 90064 | 2018-04-13 |
1487153474 | Victor Louie | Behavior Technician | 11835 W Olympic Blvd Suite 140e, Los Angeles, CA 90064 | 2018-02-06 |
1538683842 | Ana Grinfeld | Behavioral Analyst | 11835 W Olympic Blvd Ste 140e, Los Angeles, CA 90064 | 2017-07-28 |
1407386089 | Ovsanna Stepanyan | Rehabilitation Practitioner | 11080 W Olimpic Blvd, La, CA 90064 | 2017-06-15 |
1952768012 | Grace Gayles | Behavioral Analyst | 11835 W. Olympic Blvd., Suite 140e, Los Angeles, CA 90064 | 2016-01-20 |
1669841003 | Jessica Hildebrandt | Occupational Therapy Assistant | 2446 S Westgate Ave, Los Angeles, CA 90064 | 2015-09-16 |
1033592571 | Joshua Busse | Family Medicine | 11845 Olympic Boulevard, Los Angeles, CA 90064 | 2015-07-01 |
Find all providers in zip 90064 |
Taxonomy Code | 163WG0000X |
Grouping | Nursing Service Providers |
Classification | Registered Nurse |
Specialization | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477037828 | Maria Lourdes Cabula | Registered Nurse | 2807 W Avenue 30, Los Angeles, CA 90065-1303 | 2018-09-21 |
1902175730 | Aliva Health & Wellnes Center, A Nursing Corporation | Registered Nurse | 420 East 3rd Street, Suite 810, Los Angeles, CA 90013-1647 | 2011-12-23 |
1104455625 | Nyree Minatsaghanian | Registered Nurse | 1401 S Grand Ave, Los Angeles, CA 90015-3010 | 2020-04-06 |
1073160768 | Daniel Ewing | Registered Nurse | 11301 Wilshire Blvd Bldg 402, Los Angeles, CA 90073-1003 | 2019-08-19 |
1487215927 | Vitalina B Gonzalez | Registered Nurse | 221 Westwood Plaza, Los Angeles, CA 90095-0001 | 2019-06-25 |
1134697576 | Larry U Nwafor Sr. | Registered Nurse | 11900 Avalon Blvd, Los Angeles, CA 90061-2866 | 2018-11-03 |
1295238665 | Eric Louis Shepherd | Registered Nurse | 450 Bauchet St, Los Angeles, CA 90012-2907 | 2018-03-13 |
1588024723 | Yahan Chung | Registered Nurse | 1245 Wilshire Blvd, Suite 703, Los Angeles, CA 90017-4810 | 2016-03-01 |
1396139556 | Buu-dien Le | Registered Nurse | 1200 N State St, Medical Credential, Los Angeles, CA 90033 | 2015-03-26 |
1205228699 | Lovelle Rivera | Registered Nurse | 4139 Verdugo Rd, Los Angeles, CA 90065-3820 | 2015-02-23 |
Find all providers in LOS ANGELES |
City | LOS ANGELES |
Zip Code | 90064 |
Please comment or provide details below to improve the information on FENDEE MADAYAG ANSELMO.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.