Individual
EDNAGRACE GUILLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3050 TWEEDY BLVD, SOUTH GATE, CA 90280
(323) 357-0700
Mailing address
12727 BRIAN CT, CERRITOS, CA 90703-1117
(562) 881-6545
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95002989
CA
Other
Enumeration date
04/07/2016
Last updated
04/07/2016
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