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1811562648
KHALIL STEPHON SMALL
LOS ANGELES, CA
NPI
1811562648
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2021-05-24
Last Update Date
2021-05-24
Business Address
KHALIL STEPHON SMALL BAPSY
4240 W 62ND ST
LOS ANGELES, CA 90043-3615
Phone number: 323-290-2540
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Mailing Address
KHALIL STEPHON SMALL BAPSY
5757 W CENTURY BLVD STE 303
LOS ANGELES, CA 90045-6409
Phone number: 323-290-2540
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