Individual
DESIREE MADUCDOC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1137 N CENTRAL AVE APT 1524, GLENDALE, CA 91202-3683
(702) 334-5517
Mailing address
1137 N CENTRAL AVE APT 1524, GLENDALE, CA 91202-3683
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
22850
CA
Other
Enumeration date
10/03/2013
Last updated
10/03/2013
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