Organization
AIVA HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAVONIA SIDONEY RUSSELL RN (DIRECTOR)
(310) 462-6082
Entity
Organization
Contact information
Practice address
8453 S VAN NESS AVE, INGLEWOOD, CA 90305-1519
(323) 778-1177
(323) 778-2477
Mailing address
17810 ELM CT, CARSON, CA 90746-7429
(310) 462-6082
(310) 638-3549
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
FNP 38172
CA
Other
Enumeration date
04/30/2008
Last updated
02/19/2009
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