Provider Demographics
NPI:1194139543
Name:BILAS, JOSEPHINE U (NP)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:U
Last Name:BILAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23049 ARCHIBALD AVE
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-4718
Mailing Address - Country:US
Mailing Address - Phone:818-321-7700
Mailing Address - Fax:888-444-9401
Practice Address - Street 1:6245 DELONGPRE AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90028-8253
Practice Address - Country:US
Practice Address - Phone:323-785-1223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-13
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95000671363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP95000671OtherNP LICENSE