Individual
JESUS SANDRO BRACAMONTES BARRAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
3853 ROSECRANS ST, SAN DIEGO, CA 92110-3115
(619) 692-8200
Mailing address
3853 ROSECRANS ST, SAN DIEGO, CA 92110-3115
(619) 692-8200
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
710315
CA
Other
Enumeration date
06/01/2020
Last updated
11/14/2023
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