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1376282475
MARIELLE TAVARES
LOS ANGELES, CA
NPI
1376282475
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 95020541)
Enumeration Date
2022-05-27
Last Update Date
2022-05-27
Business Address
MARIELLE TAVARES
808 W 58TH ST
LOS ANGELES, CA 90037-3632
Phone number: 310-948-6356
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Mailing Address
MARIELLE TAVARES
5743 VENTURA CANYON AVE
VALLEY GLEN, CA 91401-4533
Phone number: 310-948-6356
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