NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1265502405
ICC CONVALESCENT CORP.
4032 WILSHIRE BLVD FL 6
LOS ANGELES
CA
900103425
1104466325
EPISCOPE
EDELISA ROSE
RUSTIA
16344 VINTAGE ST
NORTH HILLS
CA
913431317
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