Individual
DESSIRE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
222 W 6TH ST, SAN PEDRO, CA 90731
(310) 833-3135
(310) 707-2877
Mailing address
855 N ORANGE GROVE BLVD, PASADENA, CA 91103-3333
(626) 796-3453
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
10/01/2008
Last updated
09/04/2018
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