Individual
MS. IDA I MAT ARIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L. AC.
Contact information
Practice address
14650 AVIATION BLVD, SUITE 225, HAWTHORNE, CA 90250-6656
(310) 536-9996
(310) 536-9997
Mailing address
14650 AVIATION BLVD, SUITE 225, HAWTHORNE, CA 90250-6656
(310) 536-9996
(310) 536-9997
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC 10965
CA
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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