Individual
IVY NIEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(323) 660-2450
Mailing address
7165 MYSTIC CLOUD CT, EASTVALE, CA 92880-3292
(626) 824-3280
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95012900
CA
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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