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1811769979
RICHARD DESMUND MEDINA
SANTA MONICA, CA
NPI
1811769979
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-10-23
Last Update Date
2023-10-23
Business Address
RICHARD DESMUND MEDINA
907 PICO BLVD
SANTA MONICA, CA 90405-1326
Phone number: 310-314-6200
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Mailing Address
RICHARD DESMUND MEDINA
907 PICO BLVD
SANTA MONICA, CA 90405-1326
Phone number: 310-314-6200
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