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JUANITO MEDINA

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
1401 S GRAND AVE, EMERGENCY DEPARTMENT, LOS ANGELES, CA 90015-3010
(213) 748-2411
Mailing address
4551 GLENCOE AVE, SUITE 260, MARINA DEL REY, CA 90292-6385
(310) 301-2030
(310) 306-5247

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP7325
CA

Other

Enumeration date
05/19/2006
Last updated
07/08/2007
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