Individual
JERONIMO SUBAYAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
74923 HOVLEY LN E, PALM DESERT, CA 92260-1927
(760) 288-4579
Mailing address
3715 E CALLE DE RICARDO APT 2, PALM SPRINGS, CA 92264-1222
(323) 809-0229
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
252073
CA
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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