GEREINE MAE CONDINO DATAN

GARDENA, CA
NPI1215537543
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: CA  F08201140)
Enumeration Date2020-10-27
Last Update Date2020-10-27
Business Address
GEREINE MAE CONDINO DATAN
500 W 190 ST
GARDENA, CA 90248
Phone number: 714-452-1961
Mailing Address
GEREINE MAE CONDINO DATAN
25612 BARTON RD # 290
LOMA LINDA, CA 92354-3110
Phone number:
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