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1629385562
TANAGON MICKE PACHECO
CULVER CITY, CA
NPI
1629385562
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2010-09-13
Last Update Date
2012-06-11
Business Address
Mr. TANAGON MICKE PACHECO
4760 SEPULVEDA BLVD
CULVER CITY, CA 90230-4820
Phone number: 310-090-6612
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Mailing Address
Mr. TANAGON MICKE PACHECO
4760 SEPULVEDA BLVD
CULVER CITY, CA 90230-4820
Phone number: 310-090-6612
Copy
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