AMANDA MARIE ILAG

BERKELEY, CA
NPI1114745783
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP2300X Nurse Practitioner, Primary Care
(Licence: CA  95032119)
Enumeration Date2024-10-01
Last Update Date2025-01-16
Business Address
AMANDA MARIE ILAG AGNP
1901 4TH ST STE 201
BERKELEY, CA 94710-1986
Phone number: 510-929-1400
Mailing Address
AMANDA MARIE ILAG AGNP
PO BOX 511250
LOS ANGELES, CA 90051-7805
Phone number: 510-929-1400