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1255162061
ISAAC MIEDEMA ERICSON
LOS ANGELES, CA
NPI
1255162061
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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
2024-08-13
Last Update Date
2024-08-13
Business Address
ISAAC MIEDEMA ERICSON
885 TIVERTON AVE
LOS ANGELES, CA 90095
Phone number: 310-825-6373
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Mailing Address
ISAAC MIEDEMA ERICSON
885 TIVERTON AVE
LOS ANGELES, CA 90095
Phone number: 310-825-6373
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