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1225898372
DANIEL LAWRENCE POLYAKOV
LOS ANGELES, CA
NPI
1225898372
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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
2024-03-19
Last Update Date
2024-03-19
Business Address
DANIEL LAWRENCE POLYAKOV
1200 N STATE ST
LOS ANGELES, CA 90089-1001
Phone number: 714-512-0466
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Mailing Address
DANIEL LAWRENCE POLYAKOV
1200 N STATE ST # C4E100
LOS ANGELES, CA 90089-1001
Phone number: 714-512-0466
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