Individual
CHARLIAN ISATA BANGALIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13622 CHADRON AVE APT 12, HAWTHORNE, CA 90250-9246
(424) 219-2501
Mailing address
13622 CHADRON AVE APT 12, HAWTHORNE, CA 90250-9246
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
240234
CA
Other
Enumeration date
10/23/2024
Last updated
10/23/2024
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