Individual
MARCOS ELISEO CHACON VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
851 S SUNSET AVE APT T220, WEST COVINA, CA 91790-5510
(323) 712-1840
Mailing address
200 E ROWLAND ST # 237, COVINA, CA 91723-3146
(323) 712-1840
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
02271594
CA
Other
Enumeration date
09/26/2023
Last updated
03/17/2026
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