Individual
JACOB PAUL GALLARDOFOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
450 E SAN JACINTO AVE, PERRIS, CA 92571-2833
(951) 443-2299
Mailing address
44090 KARIE WAY, TEMECULA, CA 92592-1464
(951) 719-9055
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/29/2022
Last updated
12/29/2022
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