Organization
AMBROSE HILLS WELLNESS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILICA STEFANOVIC MD (MD)
(323) 644-1998
Entity
Organization
Contact information
Practice address
4448 AMBROSE AVE, LOS ANGELES, CA 90027-2115
(323) 644-1998
Mailing address
4448 AMBROSE AVE, LOS ANGELES, CA 90027-2115
(323) 644-1998
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FNP544593
FICTITIOUS NAME PERMIT
CA
Enumeration date
06/24/2015
Last updated
11/23/2015
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