Individual
LUZ EDITH ORTIZ GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14525 LAKEWOOD BLVD STE A, PARAMOUNT, CA 90723-3638
(562) 205-8091
Mailing address
14101 PARAMOUNT BLVD, PARAMOUNT, CA 90723-2607
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA94499
CA
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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