Individual
MR. RODOLFO LARA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
11221 VAN BUREN AVE, LOS ANGELES, CA 90044-1333
(323) 755-1385
Mailing address
11221 VAN BUREN AVE, LOS ANGELES, CA 90044-1333
(323) 755-1385
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
600462
CA
Other
Enumeration date
10/20/2011
Last updated
10/20/2011
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