Individual
LETICIA RODRIGUEZ BOUTROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
4650 W SUNSET BLVD, MS# 113, LOS ANGELES, CA 90027-6062
(323) 669-2109
(323) 953-8519
Mailing address
6430 W SUNSET BLVD, SUITE 600, LOS ANGELES, CA 90028-7901
(323) 669-2337
(323) 644-8488
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
NPF10287
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0102870
—
CA
Enumeration date
09/30/2006
Last updated
07/08/2007
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