Individual
MR. IDRISS O FASSASSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, MPH
Contact information
Practice address
245 S FETTERLY AVE, LOS ANGELES, CA 90022-1605
(323) 362-1010
Mailing address
245 S FETTERLY AVE, LOS ANGELES, CA 90022-1605
(323) 362-1010
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95278415
CA
Other
Enumeration date
12/16/2022
Last updated
12/16/2022
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