Individual
ISSAM DALE BOUIDIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5066 ROMAINE ST APT 7, LOS ANGELES, CA 90029-2599
(213) 846-6581
Mailing address
5066 ROMAINE ST APT 7, LOS ANGELES, CA 90029-2599
(213) 846-6581
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
05/14/2025
Last updated
05/14/2025
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