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1750168076
CORA RIDENOUR
LOS ANGELES, CA
NPI
1750168076
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA PA63295)
Enumeration Date
2023-09-11
Last Update Date
2023-09-11
Business Address
CORA RIDENOUR
8631 W 3RD ST # 815E
LOS ANGELES, CA 90048-5901
Phone number: 310-858-2224
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Mailing Address
CORA RIDENOUR
3325 N 148TH CT APT 3101
OMAHA, NE 68116-7214
Phone number: 402-594-8695
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