Individual
FREDERIC MASSOUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6417 CRENSHAW BLVD APT 15, LOS ANGELES, CA 90043-3971
(424) 221-0662
Mailing address
6417 CRENSHAW BLVD APT 15, LOS ANGELES, CA 90043-3971
(424) 221-0662
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
LN281611
CA
Other
Enumeration date
09/19/2017
Last updated
07/21/2022
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