Individual
MR. KEISUKE MENJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
12898 TOWNE CENTER DR, CERRITOS, CA 90703-8546
(562) 622-2800
(562) 741-4479
Mailing address
12900 PARK PLAZA DR # 3150, CERRITOS, CA 90703-9329
(562) 622-2800
(714) 741-4479
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AG08180103
CA
Other
Enumeration date
09/14/2018
Last updated
09/27/2019
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