Individual
OSCAR IGLESIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9842 13TH ST STE B, GARDEN GROVE, CA 92844-3171
(714) 531-4624
(714) 531-1189
Mailing address
9842 13TH ST STE B, GARDEN GROVE, CA 92844-3171
(714) 531-4624
(714) 531-1189
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
101YA0400X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1001YA0400X
HOUSE MANAGER
CA
Enumeration date
10/06/2006
Last updated
07/08/2007
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