Individual
JOSEPH NGWA TANIFOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
11712 HAWTHORNE BLVD, HAWTHORNE, CA 90250-2324
(310) 679-9293
Mailing address
22620 OCEAN AVE APT 18, TORRANCE, CA 90505-3643
(323) 839-7302
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
NP19411
CA
364SG0600X
Gerontology Clinical Nurse Specialist
CNS3298
CA
Other
Enumeration date
08/31/2010
Last updated
08/31/2010
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