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1336662501
IVY GRACE BAS DUENAS
LOS ANGELES, CA
NPI
1336662501
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
Additional Taxonomies
225400000X Rehabilitation Practitioner
Enumeration Date
2017-07-19
Last Update Date
2023-06-08
Business Address
IVY GRACE BAS DUENAS
11080 W OLYMPIC BLVD
LOS ANGELES, CA 90064-1937
Phone number: 310-966-6600
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Mailing Address
IVY GRACE BAS DUENAS
11080 W OLYMPIC BLVD
LOS ANGLES, CA 90064
Phone number:
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