Individual
BEANCA FUENTES MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11301 WILSHIRE BLVD, LOS ANGELES, CA 90073-1003
(310) 478-3711
Mailing address
2225 MARTIN LUTHER KING JR AVE, LONG BEACH, CA 90806-4429
(562) 305-6333
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN95308330
CA
Other
Enumeration date
01/26/2023
Last updated
01/26/2023
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