Individual
MR. MIKE HERRERA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
57131 LAKEVIEW RD, BAKER, CA 92309
(909) 389-8582
Mailing address
1366 WHITEWOOD DR, MENTONE, CA 92359-1623
(909) 389-8582
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
360159AP
CA
Other
Enumeration date
10/16/2024
Last updated
10/16/2024
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