Individual
TANYA GIDISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(323) 660-2450
Mailing address
5406 BURNET AVE, SHERMAN OAKS, CA 91411-3506
(818) 267-4704
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95012445
CA
Other
Enumeration date
08/13/2019
Last updated
08/13/2019
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