Individual
CAROLYN DELORES BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9124 S WESTERN AVE, LOS ANGELES, CA 90047-3518
(213) 325-2348
Mailing address
9124 S WESTERN AVE, LOS ANGELES, CA 90047-3518
(213) 325-2348
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
705588
CA
183700000X
Pharmacy Technician
5733
CA
Other
Enumeration date
11/25/2020
Last updated
11/25/2020
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