Individual
EBBA HERRITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
400 W 30TH ST, LOS ANGELES, CA 90007-3320
(213) 284-3200
Mailing address
400 W 30TH ST, LOS ANGELES, CA 90007-3320
(213) 284-3200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA11763
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11763
PA
CA
Enumeration date
10/05/2006
Last updated
01/30/2013
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