Individual
MRS. CHEZOMA LATISSUE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4255 NILAND ST, LYNWOOD, CA 90262
(310) 365-5768
Mailing address
10003 ROSECRANS AVE, BELLFLOWER, CA 90706
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/05/2019
Last updated
09/05/2019
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