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EMILIA VELMA IVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
6801 PARK TER STE 400, LOS ANGELES, CA 90045-9212
(310) 665-7200
(844) 720-7885
Mailing address
4140 W 190TH ST, TORRANCE, CA 90504-5513
(310) 665-7200
(844) 720-7885

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3567
CT
363A00000X
Physician Assistant
Primary
53459
CA
363AS0400X
Surgical Physician Assistant
3567
CT

Other

Enumeration date
05/10/2016
Last updated
05/27/2021
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