Individual
CHANEL LONDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1453 16TH ST, SANTA MONICA, CA 90404-2715
(310) 450-4050
Mailing address
1453 16TH ST, SANTA MONICA, CA 90404-2715
(310) 450-4050
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/08/2015
Last updated
04/03/2017
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