Individual
MISS EMILYN BASUBAS LAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 ELM AVE APT 115, LONG BEACH, CA 90813-3275
(562) 704-4832
Mailing address
1100 ELM AVE APT 115, LONG BEACH, CA 90813-3275
(562) 704-4832
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
23175
CA
Other
Enumeration date
02/27/2017
Last updated
02/27/2017
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