Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blasius Teghen Agum

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1063293207

Blasius Teghen Agum is a Psychiatric/Mental Health Nurse Practitioner in Los Angeles, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2023

Practice location Address checks out

6041 Cadillac Ave
Los Angeles, CA 90034-1702
Phone: (323) 857-3161
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 95027247 (CA)

Record details

NPI number1063293207
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 12, 2023
Last updated in NPPESOctober 12, 2023
Certification dateOctober 12, 2023

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