Magnolia Nursing Professional Corporation

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

MAGNOLIA NURSING PROFESSIONAL CORPORATION

Practice address

3435 Wilshire Blvd Ste 2780
Los Angeles, CA 90010-1901

Phone

(714) 785-3639

NPI assigned

Jan 19, 2022

Organization subpart

No

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

Authorized official

Name

Christian Reyes, FNPNPI 1538782214

Title

President

Phone

(714) 785-3639

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christian Reyes

  • Family Nurse Practitioner
  • Los Angeles, CA
  • NPI 1538782214
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1629720883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8453 PENNY DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925031488",
            "telephone_number": "714-785-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 WILSHIRE BLVD STE 2780",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101901",
            "telephone_number": "714-785-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA NURSING PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-785-3639",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Albert Magnaye
• Hillery Magness, MS, ATC
• Magnifent Home Health Care Inc.
• Magnifent Medical Management Inc
• Magnolia Access Services Inc
• Magnolia Wellness Center, Inc.
• Nicholas Magnusson
• Katherine Elise Magolske, PTA
• Olivia Catherine Magon, M.A., CCC-SLP
• Julie Elizabeth Magorien

• Family Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, 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 Nov 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.