Provider Demographics
NPI:1922214402
Name:AVILA, MARGARET (RN-NP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:AVILA
Suffix:
Gender:F
Credentials:RN-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 E 3RD ST
Mailing Address - Street 2:SUITE 810
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-1644
Mailing Address - Country:US
Mailing Address - Phone:213-625-0717
Mailing Address - Fax:213-625-0770
Practice Address - Street 1:420 E. 3RD STREET
Practice Address - Street 2:SUITE 810
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-1644
Practice Address - Country:US
Practice Address - Phone:213-625-0717
Practice Address - Fax:231-625-0770
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 207786363LA2200X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARB 207786OtherBRN