Individual
DR. EBONIE MICHELE VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4760 SEPULVEDA BLVD, CULVER CITY, CA 90230-4820
(310) 390-6612
Mailing address
4760 SEPULVEDA BLVD, CULVER CITY, CA 90230-4820
(310) 390-6612
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A104737
CA
Other
Enumeration date
05/29/2007
Last updated
12/14/2021
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