Individual
CARLY ROSE DEVIRIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
808 W 58TH ST, LOS ANGELES, CA 90037-3632
(323) 541-1411
Mailing address
808 W 58TH ST, LOS ANGELES, CA 90037-3632
(310) 560-8570
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95013513
CA
Other
Enumeration date
02/28/2020
Last updated
07/10/2020
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