Individual
SE RA PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9333 IMPERIAL HWY, DOWNEY, CA 90242-2812
(833) 574-2273
Mailing address
1203 W 164TH ST APT 3, GARDENA, CA 90247-4885
(213) 332-4140
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
95001909
CA
Other
Enumeration date
08/29/2014
Last updated
05/26/2023
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