Individual
MR. OMAR A MEDINA I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12411 SLAUSON AVE STE H, WHITTIER, CA 90606-2835
(562) 693-5449
Mailing address
666 BRADSHAWE AVE, LOS ANGELES, CA 90022-3403
(909) 542-5204
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
4213
CA
Other
Enumeration date
07/06/2018
Last updated
07/06/2018
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