Individual
PENELOPE GRACE KORNBLUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N, NP, MSN
Contact information
Practice address
8631 W 3RD ST, SUITE 800E, LOS ANGELES, CA 90048-5901
(310) 423-0840
Mailing address
8631 W 3RD ST, SUITE 800E, LOS ANGELES, CA 90048-5901
(310) 423-0840
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
16805
CA
Other
Enumeration date
06/18/2007
Last updated
07/08/2007
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