Ni Ketut Supiyati
NPI #1023497443 in Huntington Park, California
Provider Information
- NPI Number
- 1023497443
- Entity Type
- Individual
- Name
- Ni Ketut Supiyati
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- May 19, 2015
- Last Updated
- May 19, 2015
Practice Location
- Address
- 2638 E FLORENCE AVE
- City
- Huntington Park
- State
- California
- ZIP Code
- 90255-4708
- Phone
- (323) 581-4665
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner |
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