Individual
MR. DE WAYNE D DELA GUERRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
928 N WESTERN AVE APT 306, LOS ANGELES, CA 90029-3872
(619) 793-9848
(323) 544-0899
Mailing address
PO BOX 74654, LOS ANGELES, CA 90004-0654
(619) 793-9848
(323) 417-4865
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
LPN02498
WA
164X00000X
Licensed Vocational Nurse
Primary
240-636
CA
Other
Enumeration date
11/27/2012
Last updated
08/26/2020
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