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1205119286
ETHAN MICHAEL TREVIS
DOWNEY, CA
NPI
1205119286
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261QM0855X Clinic/Center, Adolescent and Children Mental Health
Enumeration Date
2011-09-26
Last Update Date
2021-02-09
Business Address
ETHAN MICHAEL TREVIS
10927 DOWNEY AVE
DOWNEY, CA 90241-3739
Phone number: 562-869-9770
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Mailing Address
ETHAN MICHAEL TREVIS
10927 DOWNEY AVE STE C
DOWNEY, CA 90241-3739
Phone number: 562-450-3304
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