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General NPI Number Information
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NPI Number | 1043587819
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Entity Type | Individual
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Provider Name | ROBERT CORDOVA NP
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Gender | Male
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Dates
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Enumeration Date | 11/22/2011
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Last Update Date | 06/01/2020
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Provider Practice Location Address
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Address Line | 1100 NORTH STATE STREET CLINIC TOWER A4A
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City | LOS ANGELES
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State | CA
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Zip | 90033
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Country | US
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Telephone | 562-225-1231
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Fax | 323-441-8143
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Provider Business Mailing Address
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Address Line | 2532 QUIET SANDS DR
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City | SIGNAL HILL
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State | CA
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Zip | 90755-3800
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Country | US
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Telephone | 562-225-1231
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP21405
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License Number State | CA
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