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Individual

MRS. KALESHA GONZALEZ GONZALEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
IDMT

Contact information

Practice address
21118 AMIE AVENUE, TORRANCE, CA 90503
(310) 707-6453
Mailing address
21118 AMIE AVENUE, TORRANCE, CA 90503
(310) 707-6453

Taxonomy

Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary

Other

Enumeration date
03/06/2012
Last updated
03/06/2012
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