Medigence Health NJ, PC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

MEDIGENCE HEALTH NJ, PC

Practice address

10960 Wilshire Blvd Ste 406
Los Angeles, CA 90024-3704

Phone

(888) 836-0510

NPI assigned

Jan 21, 2025

Organization subpart

No

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

Authorized official

Name

Olubusola Abiye Brimmo

Title

President/Owners

Phone

(888) 836-0510

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1737417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1790597490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10960 WILSHIRE BLVD STE 406",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900243704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10960 WILSHIRE BLVD STE 406",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900243704",
            "telephone_number": "888-836-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIGENCE HEALTH NJ, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "BRIMMO",
        "authorized_official_first_name": "OLUBUSOLA",
        "authorized_official_middle_name": "ABIYE",
        "authorized_official_title_or_position": "PRESIDENT/OWNERS",
        "authorized_official_telephone_number": "888-836-0510"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.

Verify at the official NPI Registry.