Individual
MR. HEGEL G ORDAZ GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
5310 FOUNTAIN AVE, LOS ANGELES, CA 90029-1005
(323) 461-9961
Mailing address
1216 N ALEXANDRIA AVE, LOS ANGELES, CA 90029-1404
(323) 347-9329
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5624
CA
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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