Individual
MONIQUE AUTUM GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1821 CRENSHAW BLVD APT 203, LOS ANGELES, CA 90019-6079
(323) 798-6426
Mailing address
1821 CRENSHAW BLVD APT 203, LOS ANGELES, CA 90019-6079
(323) 798-6426
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
D5730528
CA
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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