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Individual

ZACH ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BT

Contact information

Practice address
3424 MOTOR AVE, LOS ANGELES, CA 90034-4710
(310) 916-7850
Mailing address
1368 S RIDGELEY DR, LOS ANGELES, CA 90019-2659
(310) 916-7850

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
CA

Other

Enumeration date
07/12/2019
Last updated
07/12/2019
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