Individual
HAIDEE TABANAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-BC
Contact information
Practice address
11500 BROOKSHIRE AVE, DOWNEY, CA 90241-4917
(562) 904-5000
Mailing address
11500 BROOKSHIRE AVE, DOWNEY, CA 90241-4917
(562) 904-5000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95025755
CA
Other
Enumeration date
07/20/2023
Last updated
08/22/2024
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