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1114602604
DAVID WALLACE
LOS ANGELES, CA
NPI
1114602604
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2023-06-21
Last Update Date
2023-06-21
Business Address
DAVID WALLACE
155 BIMINI PL
LOS ANGELES, CA 90004-5902
Phone number: 213-388-5423
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Mailing Address
DAVID WALLACE
155 BIMINI PL
LOS ANGELES, CA 90004-5902
Phone number: 213-388-5423
Copy
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