Individual
EDEN JENNING REYNOSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11303 W WASHINGTON BLVD, LOS ANGELES, CA 90066-6003
(310) 482-6600
Mailing address
11303 W WASHINGTON BLVD, LOS ANGELES, CA 90066-6003
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95109481
CA
Other
Enumeration date
03/15/2023
Last updated
03/15/2023
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