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Individual

MR. JON-ERIC MEDINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LVN

Contact information

Practice address
526 S SAN PEDRO ST, LOS ANGELES, CA 90013-2102
(213) 488-9559
Mailing address
526 S SAN PEDRO ST, LOS ANGELES, CA 90013-2102
(213) 488-9559

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN 227591
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ICAN808
LA COUNTY DMH
CA
Enumeration date
05/30/2008
Last updated
05/16/2011
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