Organization
SACRED ENTRANCE MIDWIFERY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEKSANDRA EVANGUEULIDI L.M., CPM (OWNER)
(310) 566-7690
Entity
Organization
Contact information
Practice address
11965 VENICE BLVD, SUITE# 204, LOS ANGELES, CA 90066-3979
(310) 566-7690
(310) 566-7699
Mailing address
11965 VENICE BLVD, SUITE# 204, LOS ANGELES, CA 90066-3979
(310) 566-7690
(310) 566-7699
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
201
CA
Other
Enumeration date
05/30/2007
Last updated
12/09/2010
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