Individual
GENESIS LIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1730 W. SEPULVEDA BLVD. SUITE #1, TORRANCE, CA 90501
(310) 325-8888
Mailing address
1730 SEPULVEDA BLVD STE 1, TORRANCE, CA 90501-6901
(310) 325-8888
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
07/26/2010
Last updated
07/26/2010
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