Individual
PABLO DE JESUS CRUZ LANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13876 HARBOR BLVD STE 3B, GARDEN GROVE, CA 92843-4029
(714) 909-5817
Mailing address
2014 MABURY ST, SANTA ANA, CA 92705-7149
(714) 909-5581
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
A7604227
CA
Other
Enumeration date
07/04/2022
Last updated
07/04/2022
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