Individual provider · Type 1 NPI
Mai Chou Vang, NURSE PRACTITIONER
Gerontology Nurse Practitioner · Inglewood, CA
NPI number
1063973923
Active
Practice location
555 E Hardy St
Inglewood, CA 90301-4011
Mailing address
160 S Virgil Ave Apt 207
Los Angeles, CA 90004-6036
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | AG11200008 (CA) |
| Registered Nurse | 163W00000X | 95175565 (CA) |
Gerontology Nurse Practitioner: Definition to come...
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About NPI 1063973923
Mai Chou Vang, NURSE PRACTITIONER's National Provider Identifier is 1063973923, issued on Mar 25, 2019. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Inglewood, CA. The record was last updated on Aug 19, 2021.