Organization
EAGLE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL FUENTES (OWNER)
(209) 251-3568
Entity
Organization
Contact information
Practice address
438 ALPEN ROSE WAY, GALT, CA 95632-2062
(209) 251-3568
Mailing address
438 ALPEN ROSE WAY, GALT, CA 95632-2062
(209) 251-3568
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
11/23/2019
Last updated
09/24/2020
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