Individual
MR. JODY VAUGHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
4335 ATLANTIC AVE, LONG BEACH, CA 90807-2803
(562) 216-4900
Mailing address
4335 ATLANTIC AVE, LONG BEACH, CA 90807-2803
(562) 216-4900
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN291629
CA
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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