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1104490796
ELISSE VASSALLO
MARINA DEL REY, CA
NPI
1104490796
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 95017219)
Enumeration Date
2021-05-18
Last Update Date
2022-09-29
Business Address
ELISSE VASSALLO FNP-BC
4676 ADMIRALTY WAY STE 301
MARINA DEL REY, CA 90292-6601
Phone number: 310-673-3945
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Mailing Address
ELISSE VASSALLO FNP-BC
228 VIA LOS MIRADORES
REDONDO BEACH, CA 90277-6760
Phone number: 908-892-0781
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