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Individual

HAROLD AUGUSTO GOMEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSN,FNP

Contact information

Practice address
1220 S GLENDORA AVE, WEST COVINA, CA 91790-4924
(626) 290-2923
Mailing address
1220 S GLENDORA AVE, WEST COVINA, CA 91790-4924

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
NP9216
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP0092160
CA
Enumeration date
06/17/2005
Last updated
08/26/2010
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