Provider Information for 1003931627
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Ms. IDALIA RAZO
Sex: Female
NPI: 1003931627
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1003931627 | ||||||||
| Enumeration Date | 2007-03-20 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3711 LONG BEACH BLVD SUITE 600 LONG BEACH, CA 90807-3315 United States Phone: 562-485-3038 | Fax:562-981-7569 | ||||||||
| Primary Practice Address | 3711 LONG BEACH BLVD SUITE 600 LONG BEACH, CA 90807-3315 United States Phone: 562-485-3038 | Fax:562-981-7569 | ||||||||
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