Individual
LYDIA SUWITA DANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
4650 SUNSET BLVD., MAILSTOP 66, LOS ANGELES, CA 90027-6062
(323) 361-4148
Mailing address
4650 SUNSET BLVD., MAILSTOP 66, LOS ANGELES, CA 90027-3632
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95002749
CA
Other
Enumeration date
07/25/2015
Last updated
09/13/2018
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