Individual
MRS. ERENEA DAR JUAN VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3113 BIG DALTON AVE, UNIT B, BALDWIN PARK, CA 91706-5106
(626) 475-2296
(626) 962-7371
Mailing address
3113 BIG DALTON AVE, UNIT B, BALDWIN PARK, CA 91706-5106
(626) 475-2296
(626) 962-7371
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
991572
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
991572
BUSINESS LICENSE
CA
Enumeration date
05/21/2008
Last updated
05/21/2008
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