Individual
JUAN TAMAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5901 W CENTURY BLVD, LOS ANGELES, CA 90045-5411
(310) 215-6020
Mailing address
4847 W BROADWAY, HAWTHORNE, CA 90250-3554
(310) 251-9115
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
48330
CA
Other
Enumeration date
05/08/2024
Last updated
05/08/2024
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