Christian Agustin, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95020017 Issued in CA

Practice address

14729 S Vermont Ave
Gardena, CA 90247-3001

Phone

(310) 756-8052

NPI assigned

Oct 14, 2022

Last updated

Oct 14, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1386360006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14729 S VERMONT AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14729 S VERMONT AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473001",
            "telephone_number": "310-756-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUSTIN",
        "first_name": "CHRISTIAN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Gardena, CA
• Providers in Gardena, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.