| Amanda Rhoads, | |
|
740 S Allied Way, El Segundo, CA 90245-5514 | |
| (310) 500-2045 | |
| Not Available |
| Full Name | Amanda Rhoads |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 740 S Allied Way, El Segundo, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164822789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 60502434 (Washington) | Primary |
| Entity Name | Providence Saint Johns Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770093734 PECOS PAC ID: 0840548624 Enrollment ID: O20180810000904 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Rhoads, 1 Embarcadero Ctr Ste 1900, San Francisco, CA 94111-3723 Ph: (415) 658-6791 | Amanda Rhoads, 740 S Allied Way, El Segundo, CA 90245-5514 Ph: (310) 500-2045 |
Kenn Rafanan, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2101 Rosecrans Ave # 3230, El Segundo, CA 90245 Phone: 323-628-8671 | |
Megan Puyau, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 390 N Pacific Coast Hwy Ste 2060, El Segundo, CA 90245 Phone: 855-427-2778 Fax: 424-277-6085 | |
Rachel Spata, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2330 Utah Ave Ste 200, El Segundo, CA 90245 Phone: 424-290-8004 | |
Nirlaip Kaur Chahal, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 300 Continental Blvd, El Segundo, CA 90245 Phone: 310-658-3775 | |
Mrs. Rani Saiju John, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 300 Continental Blvd Ste 635, El Segundo, CA 90245 Phone: 562-335-2730 | |
Young Shin, N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2101 Rosecrans Ave # 3230, El Segundo, CA 90245 Phone: 323-628-8671 | |
Rodel Lumanog, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2101 Rosecrans Ave # 3230, El Segundo, CA 90245 Phone: 323-628-8671 |