Individual
MS. ANDREA PANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CPNP-PC, CNS
Contact information
Practice address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(323) 361-2471
Mailing address
690 S CATALINA ST UNIT PH-N, LOS ANGELES, CA 90005-1740
(310) 617-7463
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
797485
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
797485
REGISTERED NURSE
CA
01
—
NP95007389
NURSE PRACTITIONER
CA
Enumeration date
06/14/2019
Last updated
03/07/2023
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