Individual
JUAN C CIFUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10938 VANOWEN ST, NORTH HOLLYWOOD, CA 91605-6407
(818) 760-2461
(818) 760-1105
Mailing address
10938 VANOWEN ST, NORTH HOLLYWOOD, CA 91605-6407
(818) 760-2461
(818) 760-1105
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891872594
—
CA
Enumeration date
07/05/2006
Last updated
12/03/2019
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