Individual
MICHELLE MODINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1230 W 3RD ST, 4TH FLOOR, LOS ANGELES, CA 90017-1408
(213) 481-2511
(213) 481-1913
Mailing address
11529 JAMES ST, CERRITOS, CA 90703-7410
(562) 402-4675
(562) 402-4675
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
NP12537
CA
363LA2200X
Adult Health Nurse Practitioner
NP12537
CA
363LG0600X
Gerontology Nurse Practitioner
NP12537
CA
363LS0200X
School Nurse Practitioner
NP12537
CA
363LW0102X
Women's Health Nurse Practitioner
Primary
NP12537
CA
Other
Enumeration date
09/16/2008
Last updated
09/16/2008
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