Individual
MRS. DORLISHA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
11301 WILSHIRE BLVD, LOS ANGELES, CA 90073
(310) 478-3711
(310) 268-4948
Mailing address
910 E SERVICE AVE APT C, WEST COVINA, CA 91790-3783
(323) 365-6256
(310) 268-4948
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN 207910
CA
Other
Enumeration date
04/29/2008
Last updated
04/29/2008
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