Individual
COYO MELESCIO BURCIAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
155 N OCCIDENTAL BLVD, LOS ANGELES, CA 90026-4641
(213) 381-2931
Mailing address
155 N OCCIDENTAL BLVD, LOS ANGELES, CA 90026-4641
(213) 381-2931
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT 30761
CA
Other
Enumeration date
02/07/2007
Last updated
08/07/2024
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