Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 23555 | CA |
NPI | 1033543533 |
---|---|
Provider Name | Stephanie Tiempo Bitanga |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90089-1019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2013 |
Last Update Date | 15/09/2020 |