Individual
MYLA DOMONDON ILAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4101 FAIRWAY DR, SOQUEL, CA 95073-3002
(831) 201-4785
(831) 201-4786
Mailing address
4101 FAIRWAY DR, SOQUEL, CA 95073-3002
(831) 201-4785
(831) 201-4786
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
445202879
CA
Other
Enumeration date
02/05/2024
Last updated
02/05/2024
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