Most Relevant Information
Provider Data
| NPI Number: | 1003654286 |
| Provider Name: | GISSELLE DIANE NAVARRO-LOPEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/19/2024 |
| Last Updated: | 07/19/2024 |
Provider Practice Location
333 S BEAUDRY AVE
LOS ANGELES
CA
900171466
Practice Location Phone/Fax
| Phone: | 2132413841 |
| Fax: | 2132413305 |
Provider Mailing Location
333 S BEAUDRY AVE
LOS ANGELES
CA
900171466
Provider Mailing Phone/Fax
| Phone: | 2132413841 |
| Fax: | 2132413305 |