Individual
MR. DALANCE RAVONCE LAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1224 VINE ST, LOS ANGELES, CA 90038-1612
(323) 769-6100
Mailing address
1224 VINE ST, LOS ANGELES, CA 90038-1612
(323) 769-6100
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
11/15/2006
Last updated
05/28/2025
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