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1114745783
AMANDA MARIE ILAG
BERKELEY, CA
NPI
1114745783
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
(Licence: CA 95032119)
Enumeration Date
2024-10-01
Last Update Date
2025-01-16
Business Address
AMANDA MARIE ILAG AGNP
1901 4TH ST STE 201
BERKELEY, CA 94710-1986
Phone number: 510-929-1400
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Mailing Address
AMANDA MARIE ILAG AGNP
PO BOX 511250
LOS ANGELES, CA 90051-7805
Phone number: 510-929-1400
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