Individual
MARISOL FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SFIDC
Contact information
Practice address
5929 DENVER AVE, LOS ANGELES, CA 90044-6319
(310) 740-5109
Mailing address
5929 DENVER AVE, LOS ANGELES, CA 90044-6319
(310) 740-5109
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
12/17/2014
Last updated
12/17/2014
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