Individual
BENJAMIN PETER CIOPPA-FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1891 EFFIE ST, LOS ANGELES, CA 90026-1711
(323) 644-2000
Mailing address
1891 EFFIE ST, LOS ANGELES, CA 90026-1711
(323) 644-2000
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95021266
CA
Other
Enumeration date
07/09/2022
Last updated
09/16/2022
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