Individual
KELLY CHEN LIAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP, RN
Contact information
Practice address
1245 16TH ST, SANTA MONICA, CA 90404-1235
(310) 453-9010
Mailing address
10573 WELLWORTH AVE, LOS ANGELES, CA 90024-5139
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
NP 11745
CA
Other
Enumeration date
06/25/2007
Last updated
07/08/2007
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