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1902654544
DERRICK J DIZON
LOS ANGELES, CA
NPI
1902654544
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: CA 305377)
Enumeration Date
2024-05-08
Last Update Date
2024-05-08
Business Address
DERRICK J DIZON
619 N FAIRFAX AVE
LOS ANGELES, CA 90036-1714
Phone number: 323-651-0043
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Mailing Address
DERRICK J DIZON
10938 SANTA CLARA CT
RANCHO CUCAMONGA, CA 91701-4432
Phone number: 626-824-2985
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