Individual
JALEEL AZIM GILMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
879 W 190TH ST STE 400-56, GARDENA, CA 90248-4220
(323) 702-6890
Mailing address
879 W 190TH ST STE 400-56, GARDENA, CA 90248-4220
(323) 702-6890
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
56751
CA
Other
Enumeration date
03/22/2007
Last updated
06/10/2025
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