Active NPI
Gwen Lee Tabaldo
- Ambulatory Care Registered Nurse
- Van Nuys, CA
National Provider Identifier
1669902045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Registered Nurse
- License
- 519751
- Practice address
- 7515 Van Nuys Blvd
Van Nuys, CA 91405-1949 - Phone
- (818) 627-3000
- NPI assigned
- Jun 18, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Registered Nurse | 163WP2201X | 519751 | CA | Primary |
Addresses
Primary practice location
7515 Van Nuys Blvd
Van Nuys, CA 91405-1949
Mailing address
7515 Van Nuys Blvd
Van Nuys, CA 91405-1949
Phone (818) 627-3000
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 519751 | CA | MD | Ambulatory Care Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1669902045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7515 VAN NUYS BLVD",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914051949",
"telephone_number": "818-627-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7515 VAN NUYS BLVD",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914051949",
"telephone_number": "818-627-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABALDO",
"first_name": "GWEN LEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-18",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "163WP2201X",
"taxonomy_group": "",
"desc": "Registered Nurse, Ambulatory Care",
"state": "CA",
"license": "519751",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.