Calloway, Breidi A.
Calloway, Breidi A. is an sole proprietor health care provider with primary practice located at 1441 Eastlake Ave Nor 8302E, Los Angeles CA 90089-0112. She recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Primary Care, Ambulatory Health Care Facilities / Oncology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Calloway, Breidi A. can be contacted via phone (323) 865-3105.Contact Information
Primary practice address
1441 Eastlake Ave Nor 8302E
Los Angeles CA 90089-0112
Phone: (323) 865-3105
Fax: (323) 865-0061
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | 18343 | California |
| Ambulatory Health Care Facilities / Oncology | 261QX0200X | 18343 | California |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 18343 | California |
Profile Details
| NPI number | 1710281233 |
|---|---|
| LBN Legal business name | Calloway, Breidi A. |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 23rd, 2010 |
| Last updated | Apr 3rd, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710281233 | NPPES |
| California | Other | W18762 | GROUP MEDICARE |
| California | Other | 1902846306 | GROUP MEDICARE |
| California | Other | GR0100430 | GROUP MEDICARE |
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