Individual
ALEX IVAN LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13527 CRAPE MYRTLE DR, MORENO VALLEY, CA 92553-4396
(951) 421-5678
(951) 421-5678
Mailing address
13527 CRAPE MYRTLE DR, MORENO VALLEY, CA 92553-4396
(951) 421-5678
(951) 421-5678
Taxonomy
Speciality
Code
Description
License number
State
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
Primary
—
CA
Other
Enumeration date
02/13/2023
Last updated
02/13/2023
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