Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 95014061 | CA |
NPI | 1003435819 |
---|---|
Provider Name | Chiara Casas |
First Address | West Hollywood, CA 90048-1804 |
Second Address | West Hollywood, CA 90048-1804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2020 |
Last Update Date | 11/04/2020 |