Healthcare Provider Details

I. General information

NPI: 1881935948
Provider Name (Legal Business Name): MS. AMELIA FELIX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2013
Last Update Date: 03/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3019 KIMBERLY DR
WEST COVINA CA
91792-2357
US

IV. Provider business mailing address

5425 POMONA BLVD
LOS ANGELES CA
90022-1716
US

V. Phone/Fax

Practice location:
  • Phone: 323-728-0411
  • Fax: 323-890-8761
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number804398
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: