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:
Health care specialties
| Specialty | Code | License # | 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 6 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 | 1619021466 | NPPES |
| California | MEDICAID | RN461352 |
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