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1770189201
OCTAVIO DESHOUN JOHNSON
LOS ANGELES, CA
NPI
1770189201
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2020-12-09
Last Update Date
2020-12-09
Business Address
Mr. OCTAVIO DESHOUN JOHNSON
5849 CROCKER ST
LOS ANGELES, CA 90003-1311
Phone number: 323-432-4399
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Mailing Address
Mr. OCTAVIO DESHOUN JOHNSON
5849 CROCKER ST
LOS ANGELES, CA 90003-1311
Phone number: 323-432-4399
Copy
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