Individual
NINA MAITHI LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
125 W THOUSAND OAKS BLVD STE 300, THOUSAND OAKS, CA 91360-4460
(805) 418-9100
Mailing address
1000 W CARSON ST # 492, TORRANCE, CA 90502-2059
(310) 222-2345
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
20A20140
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2020
Last updated
10/15/2025
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