Individual
CAROL MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4375 O NEILL ST, LOS ANGELES, CA 90032-2625
(323) 441-0411
Mailing address
4375 ONEILL STREET, LOS ANGELES, CA 90032
(323) 441-0411
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/03/2011
Last updated
11/03/2011
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