Individual
NAYELLY RUBY GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
149 S KERN AVE, LOS ANGELES, CA 90022-1626
(323) 365-1448
Mailing address
149 S KERN AVE, LOS ANGELES, CA 90022-1626
(323) 365-1448
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
87923
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87923
—
CA
Enumeration date
05/20/2020
Last updated
05/20/2020
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