Individual
ELISE SUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1011 BALDWIN PARK BLVD, BALDWIN PARK, CA 91706-5806
(626) 851-6215
Mailing address
9629 BROADWAY, TEMPLE CITY, CA 91780-3211
(602) 799-0832
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9112
CA
Other
Enumeration date
06/12/2007
Last updated
12/22/2021
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