Individual
GUILLERMO VALLEJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-7890
Mailing address
16021 PALOMINO LN, MORENO VALLEY, CA 92551-1629
(714) 456-5501
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
677299
CA
163W00000X
Registered Nurse
95000168
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
677299
CA
Other
Enumeration date
09/12/2014
Last updated
02/15/2024
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