Individual
EBONEE MACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
9010 BURKE ST UNIT 27, PICO RIVERA, CA 90660-4619
(310) 347-1222
Mailing address
5500 MING AVE STE 410, BAKERSFIELD, CA 93309-4631
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
04/29/2025
Last updated
04/29/2025
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