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Individual

FRED PESANTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
1920 MARENGO ST, LOS ANGELES, CA 90033-1317
(323) 223-4462
(323) 225-5844
Mailing address
1920 MARENGO ST, LOS ANGELES, CA 90033-1317
(323) 223-4462
(323) 225-5844

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN464309
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
464309
RN
CA
Enumeration date
10/20/2006
Last updated
07/08/2007
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