Individual
JESENIA CAMACHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 WILSHIRE BLVD, 1111, LOS ANGELES, CA 90017-1902
(310) 820-9933
Mailing address
15120 PIONEER BLVD, NORWALK, CA 90650-6449
(562) 440-8544
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
02177895
CA
Other
Enumeration date
04/22/2010
Last updated
04/22/2010
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