Organization
CELEBRITY MOBILE DNA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERISE FORD (FOUNDER)
(213) 944-4547
Entity
Organization
Contact information
Practice address
1800 VINE ST, HOLLYWOOD, CA 90028-5250
(888) 775-4362
Mailing address
6936 MORELLA AVE APT 3, NORTH HOLLYWOOD, CA 91605-6072
(213) 944-4547
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
12/05/2024
Last updated
12/10/2024
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