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Individual

BENJAMIN BARLOW SRIVIRIYA BERNARDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN, PHN

Contact information

Practice address
133 N SUNOL DR, LOS ANGELES, CA 90063-1429
(323) 362-1420
Mailing address
133 N SUNOL DR, LOS ANGELES, CA 90063-1429
(323) 362-1420

Taxonomy

Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
95236859
CA

Other

Enumeration date
07/18/2024
Last updated
07/18/2024
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