Individual
EDWIN DIMARANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 N MARIPOSA AVE, LOS ANGELES, CA 90004-4509
(213) 389-5820
Mailing address
225 N MARIPOSA AVE, LOS ANGELES, CA 90004-4509
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
28194
CA
Other
Enumeration date
06/05/2014
Last updated
06/05/2014
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