Individual
ISIS TELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10379 SLATER AVE APT 104, FOUNTAIN VALLEY, CA 92708-4798
(818) 203-4860
Mailing address
10379 SLATER AVE APT 104, FOUNTAIN VALLEY, CA 92708-4798
(818) 203-4860
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
95062518
CA
Other
Enumeration date
03/06/2020
Last updated
03/06/2020
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