Individual
MR. ALFRED FUENTES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
14127 S VERMONT AVE, GARDENA, CA 90247-2205
(310) 532-1650
(310) 532-2036
Mailing address
14127 S VERMONT AVE, GARDENA, CA 90247-2205
(310) 532-1650
(310) 532-2036
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 11705
CA
Other
Enumeration date
01/04/2012
Last updated
01/04/2012
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