Individual
DMITRIY TRETIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
4955 VAN NUYS BLVD STE 308, SHERMAN OAKS, CA 91403-1811
(818) 528-1044
Mailing address
19156 HAMLIN ST UNIT 1, RESEDA, CA 91335-5842
(818) 636-9344
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95008578
CA
Other
Enumeration date
02/27/2018
Last updated
03/16/2018
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