| Provider / Organization | NPI | Date Certified |
|---|---|---|
| TASHEENA BROADNAX | 1033997242 | 2024-06-09 |
Tasheena Broadnax is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1033997242. Registration indicates Tasheena Broadnax is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| Entity Type | Individual |
| Provider Name | Tasheena Broadnax |
| Practice Office Address | 400 W 30TH ST LOS ANGELES, CA US |
| Practice Office Telephone | 2132843200 |
| Mailing Address | 400 W 30TH ST LOS ANGELES, CA 900073320 US |
| Business Telephone | 2132843200 |
| Code | Practice | License No State |
|---|---|---|
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | PA64223
CA |