| Lia Gedamu, NP | |
|
16260 Ventura Blvd, Ll-15, Encino, CA 91436-2203 | |
| (818) 905-1567 | |
| Not Available |
| Full Name | Lia Gedamu |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 16260 Ventura Blvd, Encino, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982052684 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 95003319 (California) | Primary |
| Entity Name | Southland Renal Medical Group, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730110495 PECOS PAC ID: 3476580838 Enrollment ID: O20050718001019 |
| Mailing Address | Practice Location Address |
|---|---|
| Lia Gedamu, NP 1441 S Beverly Glen Blvd, 103, Los Angeles, CA 90024-6162 Ph: (206) 349-0842 | Lia Gedamu, NP 16260 Ventura Blvd, Ll-15, Encino, CA 91436-2203 Ph: (818) 905-1567 |
Heidi Collier, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 16133 Ventura Blvd, #360, Encino, CA 91436 Phone: 818-986-6009 Fax: 818-396-5594 | |
Carrie Elizabeth Wilson Friedman, RN,MSN, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 16055 Ventura Blvd, Suite 712, Encino, CA 91436 Phone: 818-386-1395 Fax: 888-882-6061 | |
Maya King, AGACNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 16133 Ventura Blvd Ste 360, Encino, CA 91436 Phone: 818-986-6009 Fax: 818-239-4239 | |
John Tonegato, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 16260 Ventura Blvd Ste 140, Encino, CA 91436 Phone: 818-528-2500 | |
Kelly Michele Manda, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5363 Balboa Blvd Ste 245, Encino, CA 91316 Phone: 818-343-4430 Fax: 818-343-4423 | |
Rome Diostonne Evangelista, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 16530 Ventura Blvd Ste 400, Encino, CA 91436 Phone: 818-625-4814 | |
Kristi Lynn Kuiken, MSN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 15503 Ventura Blvd Ste 240, Encino, CA 91436 Phone: 818-461-8148 Fax: 818-461-8105 |