Individual
ANGELA LASHAWN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5422 1/2 RUTHELEN ST, LOS ANGELES, CA 90062-2529
(323) 208-8597
Mailing address
5422 1/2 RUTHELEN ST, LOS ANGELES, CA 90062-2529
(323) 208-8597
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
C4561135
CA
Other
Enumeration date
10/06/2023
Last updated
10/06/2023
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