Individual
CONAN BENALLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1125 W 6TH ST, LOS ANGELES, CA 90017-1833
(213) 202-3970
Mailing address
1125 W 6TH ST, LOS ANGELES, CA 90017-1833
(213) 202-3970
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/11/2012
Last updated
06/12/2013
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