Individual provider Active NPI

Elizabeth Temitope Oluwole

  • Family Nurse Practitioner
  • Hawthorne, CA
National Provider Identifier
1467008441
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95010653 Issued in CA
Practice address
11823 Chanera Ave
Hawthorne, CA 90250-1825
Phone
(661) 448-7091
NPI assigned
Aug 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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 95010653 CA Primary

Addresses

Primary practice location

11823 Chanera Ave
Hawthorne, CA 90250-1825

Mailing address

11823 Chanera Ave
Hawthorne, CA 90250-1825
Phone (661) 448-7091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250506002410 CA Practitioner - Nurse Practitioner 9739606401 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95010653CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minghsun Liu, M.D., PC CurrentSince Apr 7, 2025 Accepting new patients
WT Health of California LLC CurrentSince Jun 25, 2025 Accepting new patients

Locations

11103 Venice Blvd
Los Angeles, CA 90034
Phone (310) 734-8526

200 S Park Rd
Ste 200
Hollywood, FL 33021
Phone (866) 986-2263

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.

NPI Registry JSON

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1467008441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11823 CHANERA AVE",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902501825",
            "telephone_number": "661-448-7091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11823 CHANERA AVE",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902501825",
            "telephone_number": "661-448-7091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUWOLE",
        "first_name": "ELIZABETH",
        "middle_name": "TEMITOPE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.