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1003591330
JUSTIN JEFFREY LAT
ORANGE, CA
NPI
1003591330
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2023-06-15
Last Update Date
2023-12-12
Business Address
JUSTIN JEFFREY LAT
265 S ANITA DR STE 102-104
ORANGE, CA 92868-3355
Phone number: 310-945-3350
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Mailing Address
JUSTIN JEFFREY LAT
9808 VENICE BLVD STE 505
CULVER CITY, CA 90232-6818
Phone number: 310-945-3350
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