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1013573757
LA DORIS JACKSON
LOS ANGELES, CA
NPI
1013573757
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2019-05-17
Last Update Date
2019-05-17
Business Address
LA DORIS JACKSON
4211 AVALON BLVD
LOS ANGELES, CA 90011-5622
Phone number: 323-233-0425
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Mailing Address
LA DORIS JACKSON
4211 AVALON BLVD
LOS ANGELES, CA 90011-5622
Phone number: 323-233-0425
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