Individual
ERA MAE CHUA GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1655 S WESTERN AVE, LOS ANGELES, CA 90006-5801
(323) 737-5200
Mailing address
4020 W 59TH ST, LOS ANGELES, CA 90043-3412
(323) 535-2111
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95014355
CA
Other
Enumeration date
04/03/2020
Last updated
04/03/2020
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