OrganizationActive
A&e Professional Medical Group and Nursing Corporation
NPI 1750017422 · Nurse Practitioner · Huntington Park, CA
Provider details
- NPI number
- 1750017422
- Entity type
- Organization
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Eden Dabalus, Secretary(310) 848-8865
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
6816 Pacific Blvd Ste 210
Huntington Park, CA 90255-4654
Phone: (818) 754-7986
Approximate (ZIP-level) locationGet directions
Mailing address
6816 Pacific Blvd
Huntington Park,, CA 90255-4654
Registry dates
- Enumerated
- 2022-07-26
- Last updated
- 2022-08-03
- Certified
- 2022-08-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.