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Individual

MIA STORM BRYANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6345 WOOSTER AVE, LOS ANGELES, CA 90056-2127
(323) 215-7565
(323) 754-8832
Mailing address
6345 WOOSTER AVE, LOS ANGELES, CA 90056-2127
(323) 215-7565
(323) 754-8832

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
D5783524
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
843685121
CA
Enumeration date
03/29/2023
Last updated
03/29/2023
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