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Individual

MISS ELIZA TINIO ORTIZLUIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LVN

Contact information

Practice address
6256 SAN RAMON WAY, BUENA PARK, CA 90620-2840
(949) 698-4904
(949) 698-4904
Mailing address
6256 SAN RAMON WAY, BUENA PARK, CA 90620-2840
(949) 698-4904
(949) 698-4904

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN213834
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A3651966
A3651966
CA
Enumeration date
05/08/2012
Last updated
05/08/2012
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