Individual
INNOCENT GOUETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1775 CHESTNUT AVE, LONG BEACH, CA 90813-1674
(562) 599-8444
Mailing address
1775 CHESTNUT AVE, LONG BEACH, CA 90813-1674
(562) 599-8444
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
242572
CA
Other
Enumeration date
10/12/2017
Last updated
10/12/2017
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