ANTONIO FONSECA

VENICE, CA
NPI1558864983
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2018-03-12
Last Update Date2018-03-12
Business Address
ANTONIO FONSECA
204 HAMPTON DR
VENICE, CA 90291-2623
Phone number: 310-309-6001
Mailing Address
ANTONIO FONSECA
204 HAMPTON DR
VENICE, CA 90291-2623
Phone number: 310-309-6001