Individual
LILY TE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, CPNP
Contact information
Practice address
2046 ATLANTIC AVE, LONG BEACH, CA 90806-4916
(562) 355-6878
Mailing address
2046 ATLANTIC AVE, LONG BEACH, CA 90806-4916
(562) 355-6878
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95000468
CA
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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