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Individual

BIANNE STEPHEN U GO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
7910 ATLANTIC AVE STE M, CUDAHY, CA 90201-5774
(323) 908-4200
Mailing address
1245 RAVENNA AVE, WILMINGTON, CA 90744-3120
(310) 818-1788

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95034113
CA

Other

Enumeration date
02/26/2025
Last updated
05/07/2025
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