Individual
MR. JESUS GAYTAN ASCENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2215 BLUE GUM AVE, MODESTO, CA 95358-1052
(209) 525-5401
(209) 525-5498
Mailing address
2118 TUCSON AVE, MODESTO, CA 95358-5944
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
CA
Other
Enumeration date
03/26/2007
Last updated
05/15/2025
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