Individual
ANNA HUMPHRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11645 WILSHIRE BLVD STE 701, LOS ANGELES, CA 90025-6810
(310) 720-6646
Mailing address
806 N HARVARD BLVD, LOS ANGELES, CA 90029-3316
(610) 973-4299
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
L9957
CA
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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