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Individual

MR. GREGORIO SAN VALENTIN AGUSTIN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
11081 ORCHARD PL, GARDEN GROVE, CA 92840-3366
(714) 310-1568
Mailing address
11081 ORCHARD PL, GARDEN GROVE, CA 92840-3366
(714) 310-1568

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
759832
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
759832
BOARD OF REGISTERED NURSING
CA
Enumeration date
10/18/2011
Last updated
10/18/2011
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