Most Relevant Information
Provider Data
| NPI Number: | 1003413055 |
| Provider Name: | ANTHONY DELOVINO LISTA APRN-CNP, FNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 1015265 |
Most Important Dates
| Enumeration Date: | 10/02/2020 |
| Last Updated: | 04/10/2024 |
Provider Practice Location
8627 ATLANTIC AVE
SOUTH GATE
CA
902803501
Practice Location Phone/Fax
| Phone: | 8884999303 |
| Fax: |
Provider Mailing Location
1325 N ANAHEIM BLVD
ANAHEIM
CA
928011202
Provider Mailing Phone/Fax
| Phone: | 8884999303 |
| Fax: |