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1508502295
MYCHAL DWAYNE JOHNSON
LOS ANGELES, CA
NPI
1508502295
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2022-05-06
Last Update Date
2022-05-06
Business Address
MYCHAL DWAYNE JOHNSON
5715 S BROADWAY
LOS ANGELES, CA 90037-4131
Phone number: 323-432-4399
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Mailing Address
MYCHAL DWAYNE JOHNSON
5849 CROCKER ST
LOS ANGELES, CA 90003-1311
Phone number:
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