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1205689783
TARAROTH PEN KEO
LANCASTER, CA
NPI
1205689783
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 95029648)
Enumeration Date
2024-04-08
Last Update Date
2024-04-08
Business Address
TARAROTH PEN KEO
43932 15TH ST W STE 103
LANCASTER, CA 93534-5234
Phone number: 661-945-7755
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Mailing Address
TARAROTH PEN KEO
1134 BRIANNA AVE
LANCASTER, CA 93535-2931
Phone number: 661-902-3369
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