Individual
MRS. SUSANNE MICHELLE MATICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.N.P.
Contact information
Practice address
4650 W SUNSET BLVD, MAILSTOP 81, LOS ANGELES, CA 90027-6062
(323) 361-5562
Mailing address
6041 CADILLAC AVE, LOS ANGELES, CA 90034-1702
(877) 608-0044
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
14305
CA
Other
Enumeration date
04/13/2010
Last updated
12/03/2021
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