Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 95002412 | CA |
N | 363LA2200X | Nurse Practitioner - Adult Health | 95002412 | CA |
N | 363LC1500X | Nurse Practitioner - Community Health | 95002412 | CA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 95002412 | CA |
N | 363LG0600X | Nurse Practitioner - Gerontology | 95002412 | CA |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 95002412 | CA |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 95002412 | CA |
N | 363LS0200X | School | 95002412 | CA |
N | 363LW0102X | Nurse Practitioner - Women's Health | 95002412 | CA |
NPI | 1073994927 |
---|---|
Provider Name | Mr. Kehinde Elemuren |
First Address | Los Angeles, CA 90018-4044 |
Second Address | Los Angeles, CA 90037-3632 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2015 |
Last Update Date | 10/05/2018 |