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1043384977
FERNANDO MALLORY
LOS ANGELES, CA
NPI
1043384977
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2006-11-20
Last Update Date
2007-07-08
Business Address
Mr. FERNANDO MALLORY
1720 E 120TH ST
LOS ANGELES, CA 90059-3052
Phone number: 310-668-4272
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Mailing Address
Mr. FERNANDO MALLORY
13348 SAVANNA
TUSTIN, CA 92782-9142
Phone number: 714-505-3344
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