Individual
LARRY RICHARD OZAETA II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
43250 MIDNIGHT CT, BANNING, CA 92220-9565
(951) 922-1725
Mailing address
5870 ARLINGTON AVE, RIVERSIDE, CA 92504-2037
(951) 683-6596
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-LESYGV
CA
Other
Enumeration date
03/12/2025
Last updated
03/12/2025
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