Individual provider · Type 1 NPI
Blasius Teghen Agum
Psychiatric/Mental Health Nurse Practitioner · Los Angeles, CA
NPI number
1063293207
Active
Practice location
6041 Cadillac Ave
Los Angeles, CA 90034-1702
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 95027247 (CA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1063293207
Blasius Teghen Agum's National Provider Identifier is 1063293207, issued on Oct 12, 2023. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Los Angeles, CA. The record was last updated on Oct 12, 2023.