Individual
MS. MAI CHOU VANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
555 E HARDY ST, INGLEWOOD, CA 90301-4011
(310) 673-4660
Mailing address
160 S VIRGIL AVE APT 207, LOS ANGELES, CA 90004-6036
(209) 406-3930
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95175565
CA
363LG0600X
Gerontology Nurse Practitioner
Primary
AG11200008
CA
Other
Enumeration date
03/25/2019
Last updated
08/19/2021
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