Individual
MS. LISA JO PETTINELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RRT, RN
Contact information
Practice address
3450 WILSHIRE BLVD, SUITE 840, LOS ANGELES, CA 90010-2208
(310) 717-9048
Mailing address
6362 COLGATE AVE, LOS ANGELES, CA 90048-4407
(310) 717-9048
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
591340
CA
2279H0200X
Home Health Registered Respiratory Therapist
00011141
CA
Other
Enumeration date
04/09/2008
Last updated
04/09/2008
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