Healthcare Provider Details

I. General information

NPI: 1083474381
Provider Name (Legal Business Name): DORIS RENEE CELI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

852-856 W 19TH STREET
SAN PEDRO CA
90731
US

IV. Provider business mailing address

24224 MADISON ST
TORRANCE CA
90505-6627
US

V. Phone/Fax

Practice location:
  • Phone: 310-519-8723
  • Fax:
Mailing address:
  • Phone: 310-739-2443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95029320
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: