Organization
CALIFORNIA STATE UNIVERSITY, LOS ANGELES
Active
Other names
Cal State Los Angeles
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS (AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
5151 STATE UNIVERSITY DR, LOS ANGELES, CA 90032-4226
(972) 367-4845
Mailing address
5050 SPRING VALLEY RD., DALLAS, TX 75244-3909
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
18176
CA
Other
Enumeration date
03/29/2017
Last updated
03/29/2017
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