Esaenwi, Tambari Nulog

Esaenwi, Tambari Nulog is an individual health care provider with primary practice located at 4618 Fountain Ave , Los Angeles CA 90029-1977. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Esaenwi, Tambari Nulog can be contacted via phone (323) 953-7170.

Contact Information

Primary practice address
4618 Fountain Ave Los Angeles CA 90029-1977
Phone: (323) 953-7170
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 461352 California
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 8465 California

Profile Details

NPI number 1619021466
LBN Legal business name Esaenwi, Tambari Nulog
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2007
Last updated Feb 25th, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619021466 NPPES
California MEDICAID RN461352

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