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Individual

DEJON STEPHENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
824 E 87TH ST, LOS ANGELES, CA 90002-1019
(323) 547-3819
Mailing address
14420 ELSWORTH ST STE 102, MORENO VALLEY, CA 92553-9027
(323) 547-3819

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
KK554811
CA

Other

Enumeration date
01/17/2022
Last updated
01/17/2022
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