Individual
IVAN MANUEL CAMPOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17800 US HIGHWAY 18, APPLE VALLEY, CA 92307-1221
(760) 552-6700
Mailing address
17800 US HIGHWAY 18, APPLE VALLEY, CA 92307-1221
(760) 552-6700
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
25934
CA
Other
Enumeration date
03/04/2017
Last updated
07/13/2021
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