Individual
AMBER RANDOLPH COREA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16314 CORNUTA AVE, BELLFLOWER, CA 90706-4814
(562) 461-9272
Mailing address
15719 EUCALYPTUS AVE, 21, BELLFLOWER, CA 90706-3852
(562) 565-3054
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
10587-R
CA
Other
Enumeration date
03/15/2017
Last updated
03/15/2017
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