Individual
LISA IAMICELI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
757 WESTWOOD PLZ, LOS ANGELES, CA 90095-8358
(310) 825-4321
Mailing address
757 WESTWOOD PLZ, LOS ANGELES, CA 90095-8358
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
651786
CA
Other
Enumeration date
09/15/2008
Last updated
10/05/2011
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