Most Relevant Information
Provider Data
| NPI Number: | 1003557984 |
| Provider Name: | COREY MORDAS |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/05/2022 |
| Last Updated: | 05/23/2024 |
Provider Practice Location
8700 BEVERLY BLVD
WEST HOLLYWOOD
CA
900481804
Practice Location Phone/Fax
| Phone: | 7742791286 |
| Fax: |
Provider Mailing Location
700 N SAN VICENTE BLVD STE G530
WEST HOLLYWOOD
CA
900695060
Provider Mailing Phone/Fax
| Phone: | 7742791286 |
| Fax: |