Rhodalyn Nanalis, | |
24578 Montevista Cir, Valencia, CA 91354-1226 | |
(661) 373-0543 | |
Not Available |
Full Name | Rhodalyn Nanalis |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 24578 Montevista Cir, Valencia, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1669837456 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 95003304 (California) | Primary |
Entity Name | Southern California Permanente Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
Mailing Address | Practice Location Address |
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Rhodalyn Nanalis, 24578 Montevista Cir, Valencia, CA 91354-1226 Ph: (661) 373-0543 | Rhodalyn Nanalis, 24578 Montevista Cir, Valencia, CA 91354-1226 Ph: (661) 373-0543 |
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