Individual
LATERYE BEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6060 N PARAMOUNT BLVD, LONG BEACH, CA 90805-3711
(562) 790-1860
Mailing address
640 W ALONDRA BLVD # 12, GARDENA, CA 90247-4563
(310) 715-6414
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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