Individual
FENDEE MADAYAG ANSELMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11845 W OLYMPIC BLVD STE 900W, LOS ANGELES, CA 90064-5086
(213) 296-3783
Mailing address
8097 CALENDULA DR, BUENA PARK, CA 90620-2005
(714) 348-4783
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
95142090
CA
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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