Individual
BONNIE TANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4760 SEPULVEDA BLVD, CULVER CITY, CA 90230-4820
(310) 390-6612
(310) 398-5690
Mailing address
2249 W 25TH ST, LOS ANGELES, CA 90018-1916
(213) 248-9280
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
374832
CA
Other
Enumeration date
01/10/2019
Last updated
01/10/2019
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