Individual
ALLISON FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3787 S VERMONT AVE, LOS ANGELES, CA 90007-4203
(323) 240-9960
Mailing address
3787 S VERMONT AVE, LOS ANGELES, CA 90007-4203
(323) 240-9960
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/01/2018
Last updated
10/01/2018
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