Individual
AMANDA LYNNE COFFEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14850 ROSCOE BLVD, PANORAMA CITY, CA 91402-4618
(818) 787-2222
Mailing address
2220 LOOMIS ST, SAN LUIS OBISPO, CA 93405-2122
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
95071702
CA
Other
Enumeration date
04/25/2018
Last updated
04/25/2018
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