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Individual

MARIE EYSSALLENNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1640 MARENGO ST, 300, LOS ANGELES, CA 90033-1036
(323) 226-2200
Mailing address
1640 MARENGO ST, 300, LOS ANGELES, CA 90033-1036

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA11819
CA

Other

Enumeration date
08/27/2007
Last updated
08/27/2007
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