Individual
CARLOS CERVANTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 SCENIC DR, MODESTO, CA 95350-6131
(209) 525-7412
Mailing address
PO BOX 3322, MODESTO, CA 95353-3322
(209) 525-7412
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Enumeration date
04/24/2019
Last updated
04/24/2019
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