Individual
AMY THIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4100 IRVING PL, CULVER CITY, CA 90232-2812
(310) 837-3796
Mailing address
4100 IRVING PL, CULVER CITY, CA 90232-2812
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
752506
CA
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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