Individual
DESIREE PACHECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12099 W WASHINGTON BLVD, LOS ANGELES, CA 90066-5882
(310) 751-1171
Mailing address
12099 W WASHINGTON BLVD, LOS ANGELES, CA 90066-5882
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
CA
Other
Enumeration date
08/09/2019
Last updated
08/09/2019
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