Individual
SUSAN LOGRONO DIZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1670 E 120TH ST, LOS ANGELES, CA 90059-3026
(424) 338-1104
Mailing address
1670 E 120TH ST, LOS ANGELES, CA 90059-3026
(424) 338-1104
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
347796
CA
Other
Enumeration date
06/20/2017
Last updated
07/21/2022
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