Provider Demographics
NPI:1033704218
Name:LONGEVITY SOLUTION NURSING, INC
Entity Type:Organization
Organization Name:LONGEVITY SOLUTION NURSING, INC
Other - Org Name:LONGEVITY SOLUTION NURSING CONSULTING INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NARGES
Authorized Official - Middle Name:
Authorized Official - Last Name:FEIZABADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-350-8757
Mailing Address - Street 1:10 CHERRY N
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2313
Mailing Address - Country:US
Mailing Address - Phone:949-350-8757
Mailing Address - Fax:
Practice Address - Street 1:10 CHERRY N
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2313
Practice Address - Country:US
Practice Address - Phone:949-636-1858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA728565OtherREGISTERED NURSE
CA95000593OtherNURSE PRACTITIONER