Individual
JOVAN IGLESIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1309 E SOMERSET PL, LONG BEACH, CA 90807-3724
(562) 773-1961
Mailing address
1309 E SOMERSET PL, LONG BEACH, CA 90807-3724
(562) 773-1961
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
198602970
CA
Other
Enumeration date
10/22/2021
Last updated
10/22/2021
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