Individual
ANTOINETTE MARIE LIZAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5715 S BROADWAY, LOS ANGELES, CA 90037-4131
(323) 948-0444
Mailing address
5715 S BROADWAY, LOS ANGELES, CA 90037-4131
(323) 948-0444
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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