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Individual

DR. BO HENRIETTE THORDARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2001 SANTA MONICA BLVD, #970-W, SANTA MONICA, CA 90404-2199
(310) 829-7878
(310) 453-5586
Mailing address
2001 SANTA MONICA BLVD, #970-W, SANTA MONICA, CA 90404-2199
(310) 829-7878
(310) 453-5586

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A51182
CA

Other

Enumeration date
09/28/2006
Last updated
12/16/2010
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