Individual
ANTOINETTE KELLUM
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
(323) 948-0443
Mailing address
5715 S BROADWAY, LOS ANGELES, CA 90037-4131
(323) 948-0444
(323) 948-0443
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/09/2010
Last updated
11/09/2010
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