Individual
JACKELYN VALLADARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
4650 W SUNSET BLVD # 68, LOS ANGELES, CA 90027-6062
(323) 361-2122
Mailing address
8000 COMANCHE AVE, WINNETKA, CA 91306-1832
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A136061
CA
Other
Enumeration date
09/16/2015
Last updated
06/07/2016
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