NPI | 1023644556 |
---|---|
Doing Business As | HOME CARE MD MEDICAL GROUP |
Entity Type | Organization |
Authorized Contact | SHYLEE BAUTISTA TIAMSON Nurse Practitioner 310-292-0117 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
Additional Taxonomies | 207Q00000X Family Medicine |
2083X0100X Preventive Medicine, Occupational Medicine | |
363AM0700X Physician Assistant, Medical | |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2020-03-16 |
Last Update Date | 2021-06-14 |