Individual
JESUS TINOCO-MALACARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, EMT
Contact information
Practice address
406 E 61ST ST, LONG BEACH, CA 90805-2904
(562) 331-8276
Mailing address
406 E 61ST ST, LONG BEACH, CA 90805-2904
(562) 331-8276
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000050115
CA
Other
Enumeration date
08/26/2021
Last updated
08/26/2021
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