Individual
CHEWEAKII ETHRIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
8033 1/2 70TH ST, PARAMOUNT, CA 90723-5440
(562) 400-3500
(310) 742-0142
Mailing address
2222 W MANCHESTER BLVD STE E, INGLEWOOD, CA 90305-2528
(562) 400-3500
(310) 999-6558
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
290133
CA
Other
Enumeration date
09/13/2015
Last updated
11/15/2016
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