Individual
GENESIS MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
867 N FAIR OAKS AVE, PASADENA, CA 91103-3050
(626) 342-9551
Mailing address
760 MOUNTAIN VIEW ST, ALTADENA, CA 91001-4925
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/11/2023
Last updated
08/11/2023
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