Active NPI
Fernand Bamba Taruc
- Gerontology Nurse Practitioner
- Glendale, CA
National Provider Identifier
1457557779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 95012147
- Practice address
- 3857 Foothill Blvd Ste 15C
Glendale, CA 91214-1658 - Phone
- (818) 319-0224
- NPI assigned
- Jun 24, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 95012147 | CA | |
| Gerontology Nurse Practitioner | 363LG0600X | 95012147 | CA | Primary |
Addresses
Primary practice location
3857 Foothill Blvd Ste 15C
Glendale, CA 91214-1658
Mailing address
11014 Eldora Ave
Sunland, CA 91040-2005
Other practice location 1
110 W Fir St Ste 4
Brea, CA 92821-6407
Phone (818) 319-0224
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95012147 | CA | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mhiramarc Healthcare Services Inc | Home Health | Current | Accepting new patients |
| Mhiramarc Management LLC Home Health Services | Home Health | Current | Accepting new patients |
Locations
8350 Foothill Blvd
Sunland, CA 91040
Phone (818) 352-9560
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Home Health Agency
- Sun Valley, CA
- NPI 1871198267
-
- Home Health Agency
- Tujunga, CA
- NPI 1942494281
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745884800000",
"number": "1457557779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11014 ELDORA AVE",
"city": "SUNLAND",
"state": "CA",
"postal_code": "910402005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3857 FOOTHILL BLVD STE 15C",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912141658",
"telephone_number": "818-319-0224"
}
],
"practiceLocations": [
{
"address_1": "110 W Fir St Ste 4",
"address_purpose": "LOCATION",
"city": "Brea",
"state": "CA",
"postal_code": "928216407",
"country_code": "US",
"telephone_number": "818-319-0224",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TARUC",
"first_name": "FERNAND",
"middle_name": "BAMBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-24",
"last_updated": "2025-04-29",
"certification_date": "2025-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Adult Health",
"state": "CA",
"license": "95012147",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Gerontology",
"state": "CA",
"license": "95012147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.