Individual
BERNARD TY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
3920 EDENHURST AVE, LOS ANGELES, CA 90039-1616
(323) 868-2588
Mailing address
3920 EDENHURST AVE, LOS ANGELES, CA 90039-1616
(323) 868-2588
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95002756
CA
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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