Individual
JESUS ENRIQUE TABARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMT
Contact information
Practice address
2333 BEVERLY BLVD STE 402-6, LOS ANGELES, CA 90057-2230
(323) 407-5491
Mailing address
4423 LOREN ST, LOS ANGELES, CA 90063-3223
(323) 407-5491
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
75025
CA
Other
Enumeration date
03/28/2018
Last updated
03/28/2018
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