Individual
LARRY EDWARD NATIVIDAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
245 S FETTERLY AVE, LOS ANGELES, CA 90022-1605
(323) 362-1079
Mailing address
245 S FETTERLY AVE, LOS ANGELES, CA 90022-1605
(323) 362-1079
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
533239
CA
Other
Enumeration date
07/10/2017
Last updated
07/10/2017
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