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NPI Code Detail

MEDICARE: ASHLEY LATRICE DIXON

MEDICARE:   ASHLEY LATRICE DIXON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1247200000XOther Technician

General Provider Information

NPI Number : 1912617523
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY LATRICE DIXON
Provider Business Mailing Address
First Line : 341 E 6TH ST
Second Line :
City : LONG BEACH
State : CA
Zip : 90802-1402
Country : US
Telephone Number : 323-424-5153
Fax Number :
Provider Business Practice Location Address
First Line : 615 ELM AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90802-1406
Country : US
Telephone Number : 424-368-4020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2022
Last Update Date : 12/05/2022

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Directions to “ ASHLEY LATRICE DIXON ” Practice Location

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