Individual
TOMAS MIGUEL LICEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3996 S HOBART BLVD, LOS ANGELES, CA 90062-1123
(323) 508-0155
Mailing address
3996 S HOBART BLVD, LOS ANGELES, CA 90062-1123
(323) 508-0155
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
4DBEA91E63
CA
Other
Enumeration date
11/20/2025
Last updated
11/20/2025
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