Individual
JORGE MANDUJANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EMT
Contact information
Practice address
5405 GARDEN GROVE BLVD, WESTMINSTER, CA 92683-1887
(626) 502-0541
Mailing address
5405 GARDEN GROVE BLVD, WESTMINSTER, CA 92683-1887
(626) 502-0541
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
E113602
CA
Other
Enumeration date
02/21/2018
Last updated
02/21/2018
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