Individual
CHRISTIAN DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
456 ELM AVE, LONG BEACH, CA 90802-2426
(562) 437-6717
Mailing address
456 ELM AVE, LONG BEACH, CA 90802-2426
(562) 437-6717
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/13/2015
Last updated
07/13/2015
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