Basic Information
Provider Information
NPI: 1730656620
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CONTE
FirstName: LUIS
MiddleName: CHRISTOPHER
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5767 W CENTURY BLVD STE 400
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900455631
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 757 WESTWOOD PLZ
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900956824
CountryCode: US
TelephoneNumber: 3108259111
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/29/2018
LastUpdateDate: 01/10/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/10/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WP0808X95101479CAN Nursing Service ProvidersRegistered NursePsych/Mental Health
363LA2100X95017696CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


Home