Individual
DAISY BANUELOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1605 EASTLAKE AVE, LOS ANGELES, CA 90033-1009
(323) 226-8611
Mailing address
2648 E WORKMAN AVE # 3001-304, WEST COVINA, CA 91791-1604
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP95025288
CA
Other
Enumeration date
06/12/2023
Last updated
06/22/2023
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