Individual
JESUS JACOB TREVINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
295 MUSTANG CT, IMPERIAL, CA 92251-2086
(760) 886-1963
Mailing address
295 MUSTANG CT, IMPERIAL, CA 92251-2086
(760) 886-1963
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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