Individual
BRENDA CARILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3787 S VERMONT AVE, LOS ANGELES, CA 90007-4203
(323) 766-2345
Mailing address
3787 S VERMONT AVE, LOS ANGELES, CA 90007-4203
(323) 766-2345
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
03/05/2012
Last updated
03/05/2012
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