Provider Demographics
NPI:1629404082
Name:REYES, MARIA DEL CARMEN (RN, FNP)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:DEL CARMEN
Last Name:REYES
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Gender:F
Credentials:RN, FNP
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Mailing Address - Street 1:3701 WILSHIRE BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2814
Mailing Address - Country:US
Mailing Address - Phone:323-361-3550
Mailing Address - Fax:323-361-8052
Practice Address - Street 1:4650 W SUNSET BLVD
Practice Address - Street 2:MS 127
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:323-361-2662
Practice Address - Fax:323-361-8820
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-17
Last Update Date:2017-12-22
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Provider Licenses
StateLicense IDTaxonomies
CANP21492363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics