Individual
ELIZABETH TIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1821 WILSHIRE BLVD STE 100, SANTA MONICA, CA 90403-5627
(310) 829-4403
Mailing address
1821 WILSHIRE BLVD STE 100, SANTA MONICA, CA 90403-5627
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95024578
CA
363LP0200X
Pediatric Nurse Practitioner
95024578
CA
Other
Enumeration date
03/22/2023
Last updated
12/18/2024
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