Individual
MR. ALEXIS MIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2080 CENTURY PARK E, SUITE 1802, CENTURY CITY, CA 90067-2001
(310) 553-9500
Mailing address
1447 16TH ST, SANTA MONICA, CA 90404-2715
(424) 757-7783
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
PENDING
CA
Other
Enumeration date
04/27/2008
Last updated
04/27/2008
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