Organization
DARYL K HOUSTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARYK KEITH HOUSTON (OWNER)
(310) 838-7381
Entity
Organization
Contact information
Practice address
3831 HUGHES AVE, 707, CULVER CITY, CA 90232-2751
(310) 838-7381
Mailing address
3831 HUGHES AVE, 707, CULVER CITY, CA 90232-2751
(310) 838-7381
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G036313
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G363130
—
CA
Enumeration date
05/24/2007
Last updated
08/22/2020
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