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1093029241
ERIC MEDINA
GARDENA, CA
NPI
1093029241
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2010-07-29
Last Update Date
2015-08-21
Business Address
-- ERIC MEDINA
15519 CRENSHAW BLVD
GARDENA, CA 90249-4525
Phone number: 310-679-9124
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Mailing Address
-- ERIC MEDINA
15519 CRENSHAW BLVD
GARDENA, CA 90249-4525
Phone number: 310-679-9124
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