Individual
ANGELIA IVE DECIERDO GONZALAES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 S SUNSET AVE, WEST COVINA, CA 91790-3940
(626) 962-4011
Mailing address
1115 S SUNSET AVE, WEST COVINA, CA 91790-3940
(626) 962-4011
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
N4600
CA
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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