Zhenghong Broyles

Individual provider Active NPI Family Nurse Practitioner · Seal Beach, CA

NPI 1447435151 · NPPES record last updated Oct 9, 2018

Key facts

NPI
1447435151
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
12743 (CA)
Practice address
921 Pacific Coast Hwy
Seal Beach, CA 90740-6244
Phone
(562) 598-0473
NPI assigned
Jan 2, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP12743CAMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12743 CA Yes
Family Nurse Practitioner 363LF0000X NP12743 CA

Addresses

Primary practice location

921 Pacific Coast Hwy
Seal Beach, CA 90740-6244

Mailing address

921 Pacific Coast Hwy
Seal Beach, CA 90740-6244
Phone (562) 598-0473

Other identifiers

IdentifierTypeStateIssuer
NP12743OtherCANP

Other providers in Seal Beach, CA

All providers in Seal Beach, CA · Family Nurse Practitioner in California

Sources for this page

Verify at the official NPI Registry.