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General NPI Number Information
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NPI Number | 1679224786
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Entity Type | Individual
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Provider Name | KEL-ANN HSIEH AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/11/2022
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 1312 HERMOSA AVE
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-3532
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Country | US
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Telephone | 424-262-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 4315 W 182ND ST UNIT 326
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City | TORRANCE
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State | CA
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Zip | 90504-4526
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Country | US
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Telephone |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | NP95016834
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License Number State | CA
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