Individual
BRYAN OMAR MALDONADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
539 N VAN NESS AVE, FRESNO, CA 93728-3419
(559) 266-9581
(559) 498-0507
Mailing address
539 N VAN NESS AVE, FRESNO, CA 93728-3419
(559) 266-9581
(559) 498-0507
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
740898
CA
Other
Enumeration date
05/13/2024
Last updated
05/19/2024
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