Individual
SUE SEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CP CFM
Contact information
Practice address
1830 W OLYMPIC BLVD STE 123, LOS ANGELES, CA 90006-3734
(213) 383-9212
(213) 383-6421
Mailing address
1830 W OLYMPIC BLVD STE 123, LOS ANGELES, CA 90006-3734
(213) 383-9212
(213) 383-6421
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
CFM02641
CA
224P00000X
Prosthetist
Primary
CP003476
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP003476
ABCOP,
CA
Enumeration date
06/26/2020
Last updated
06/26/2020
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