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Individual

MS. JUANITA MESA BLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS.

Contact information

Practice address
21630 S.FIGUEROA AVE.CAARSON,CA.90745, CARSON, CA 90745-2163
(310) 320-0730
Mailing address
21630 S.FIGUEROA AVE.CAARSON,CA.90745, 21630S.FIGUEROA AVE., CARSON, CA 90745-2163
(310) 320-0730

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
68824
CA

Other

Enumeration date
06/17/2009
Last updated
06/17/2009
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