Individual
MRS. CAMILLE C BACLAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N/A
Contact information
Practice address
510 S VERMONT AVE FL 18, LOS ANGELES, CA 90020-1912
(562) 651-5053
Mailing address
510 S VERMONT AVE, LOS ANGELES, CA 90020-1992
(213) 934-8332
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225400000X
REHABILITATION PRACTITIONER
CA
Enumeration date
09/23/2010
Last updated
07/31/2023
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