Individual
GERARDO VENEGAS HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1540 E COLORADO ST, GLENDALE, CA 91205-1514
(818) 244-7257
Mailing address
1143 STICHMAN AVE, LA PUENTE, CA 91746-1246
(626) 643-1892
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/06/2009
Last updated
12/18/2009
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