Individual
BLAIR NICOLE MOSTOFI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
13651 WILLARD ST., PANORAMA CITY, CA 91402
(818) 375-2000
Mailing address
108 S EL MOLINO AVE, UNIT 301, PASADENA, CA 91101-2583
(860) 519-3234
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0019716386
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
4290
CA
Other
Enumeration date
06/22/2012
Last updated
12/06/2021
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