Individual
DR. DANIELLE TAMMY ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
511 S FAIRFAX AVE, LOS ANGELES, CA 90036-3130
(323) 879-9259
Mailing address
511 S FAIRFAX AVE, LOS ANGELES, CA 90036-3130
(323) 879-9259
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14623
CA
Other
Enumeration date
06/18/2013
Last updated
12/08/2017
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