Individual
MRS. IDA CHEN VAN HOUTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
196 CALLA AVE, IMPERIAL BEACH, CA 91932-1004
(619) 651-5420
Mailing address
196 CALLA AVE, IMPERIAL BEACH, CA 91932-1004
(619) 651-5420
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
703637
CA
Other
Enumeration date
11/23/2011
Last updated
11/23/2011
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