MARILYN TADIAMAN PUDOL NPI 1720573439

NPI Information

NPI: 1720573439
Provider Name: MARILYN TADIAMAN PUDOL
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
2101 ROSECRANS AVE # 3230
EL SEGUNDO, CA
ZIP 90245
Phone: (323) 628-8671
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Marilyn Tadiaman Pudol is a family nurse practitioner in El Segundo, CA. Marilyn Tadiaman Pudol NPI is 1720573439. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2101 ROSECRANS AVE # 3230
EL SEGUNDO, CA
ZIP 90245-749
Phone: (323) 628-8671

The NPI 1720573439 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/25/2018 and was last updated on 10/24/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	95008725	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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