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1023744430
EBONIE FONG
LOS ANGELES, CA
NPI
1023744430
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164X00000X Licensed Vocational Nurse
(Licence: CA 723327)
Enumeration Date
2022-07-27
Last Update Date
2022-07-27
Business Address
EBONIE FONG
3125 N BROADWAY
LOS ANGELES, CA 90031-2703
Phone number: 213-482-6400
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Mailing Address
EBONIE FONG
3125 N BROADWAY
LOS ANGELES, CA 90031-2703
Phone number: 213-482-6400
Copy
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