Organization
SPECIAL SERVICE FOR GROUPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA HENMAN (PUBLIC HEALTH STUDENT)
(323) 948-0444
Entity
Organization
Contact information
Practice address
5715 S BROADWAY, LOS ANGELES, CA 90037-4131
(323) 948-0444
(323) 948-0419
Mailing address
5715 S BROADWAY, LOS ANGELES, CA 90037-4131
(323) 948-0444
(323) 948-0419
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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