Individual
RUBY MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5715 S BROADWAY, LOS ANGELES, CA 90037-4131
(323) 948-0444
Mailing address
5715 S BROADWAY, LOS ANGELES, CA 90037-4131
(323) 948-0444
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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