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Contact Information

NAITIVICTOR L ONG, PA
4733 W SUNSET BLVD
LOS ANGELES, CA90027-6021
 Phone: 323-783-4011
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for NAITIVICTOR L ONG · (Male)

NPI # 1013084862
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 11/29/2006
Last updated 09/23/2008 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • CA License # PA12661
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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