Ishita Kothari Varma, AGNP
Nurse Practitioner, Primary Care in Long Beach, CA. Individual provider (NPI-1).
NPI number1013662030
StatusActive
Last updated in NPPESFeb 17, 2022
Details
- NPI
- 1013662030
- Entity type
- Individual (NPI-1)
- Name
- Ishita Kothari Varma
- Credential
- AGNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 17, 2022
- Certification date
- Feb 17, 2022
- Last updated
- Feb 17, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP2300X | Nurse Practitioner, Primary Care | 95017804 | CA | Yes |
| 363LA2200X | Nurse Practitioner, Adult Health | 95017804 | CA | |
| 363LG0600X | Nurse Practitioner, Gerontology | 95017804 | CA |
Practice location
5901 E 7th StLong Beach, CA 90822-5201
Phone 562-826-8000
Mailing address
4116 E Addington DrAnaheim, CA 92807-2813
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