MEDICARE: GABRIELA CONTRERAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164X00000X	Licensed Vocational Nurse	704883	CA

General Provider Information

NPI Number	:	1942829338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELA CONTRERAS

Provider Business Mailing Address
First Line	:	1236 E 48TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90011-4236
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1236 E 48TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90011-4236
Country	:	US
Telephone Number	:	323-646-0778
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2020
Last Update Date	:	04/15/2020

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Directions to “ GABRIELA CONTRERAS ” Practice Location

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