Individual
JOSE L CORRALES ROMERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
510 S ALVARADO ST, LOS ANGELES, CA 90057-2904
(213) 483-3600
Mailing address
6159 MAIN ST, SOUTH GATE, CA 90280-7923
(323) 805-1351
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95045071
CA
363L00000X
Nurse Practitioner
Primary
95016937
CA
Other
Enumeration date
12/28/2020
Last updated
03/19/2021
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