Individual
IANA AZUSADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2323A E PALMDALE BLVD, PALMDALE, CA 93550-4957
(661) 223-3838
Mailing address
2323A E PALMDALE BLVD, PALMDALE, CA 93550-4957
(661) 223-3838
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
784475
CA
Other
Enumeration date
06/02/2021
Last updated
10/29/2021
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