Organization
IDOM INDUSTRIES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BYRON KEITH IDOM SR. (CEO)
(310) 671-0023
Entity
Organization
Contact information
Practice address
171 N LA BREA AVE STE 204, INGLEWOOD, CA 90301-1246
(310) 671-0023
(310) 419-9409
Mailing address
171 N LA BREA AVE STE 204, INGLEWOOD, CA 90301-1246
(310) 671-0023
(310) 419-9409
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
193471
CA
Other
Enumeration date
07/18/2012
Last updated
05/09/2013
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