Individual
FAZIELA GANDARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
PO BOX 12711, NEWPORT BEACH, CA 92658-5072
(949) 542-0546
Mailing address
PO BOX 12711, NEWPORT BEACH, CA 92658-5072
(949) 542-0546
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
95025061
CA
Other
Enumeration date
07/11/2024
Last updated
07/11/2024
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