Individual provider Active NPI

Laura Ellen Bulatao, FNP

  • Family Nurse Practitioner
  • Redondo Beach, CA
National Provider Identifier
1437915378
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95029055 Issued in CA
Practice address
1959 Kingsdale Ave
Redondo Beach, CA 90278-3417
Phone
(310) 214-1000
NPI assigned
Feb 27, 2024
Last updated
Sep 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95029055 CA Primary

Addresses

Primary practice location

1959 Kingsdale Ave
Redondo Beach, CA 90278-3417

Mailing address

1959 Kingsdale Ave
Redondo Beach, CA 90278-3417
Phone (310) 214-1000

Other names 1

  • Laura Ellen Burns Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

813 W 133Rd St
Gardena, CA 90247-1719

8711 Venice Blvd
Los Angeles, CA 90034-3216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95029055CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1437915378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 KINGSDALE AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783417",
            "telephone_number": "310-214-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 KINGSDALE AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783417",
            "telephone_number": "310-214-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULATAO",
        "first_name": "LAURA",
        "middle_name": "ELLEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-27",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "BURNS",
            "middle_name": "ELLEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.