Individual
KOUASSI KONIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
450 BAUCHET ST, LOS ANGELES, CA 90012-2907
(295) 888-4569
Mailing address
5822 CONIFER ST, OAK PARK, CA 91377
(818) 468-5669
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
15576
CA
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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