Organization
MAY AGUILAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FELICIA PONDER (OFFICE ADMINISTRATOR)
(951) 315-1265
Entity
Organization
Contact information
Practice address
22992 SERRA DR, CARSON, CA 90745-4966
(424) 558-2582
Mailing address
22992 SERRA DR, CARSON, CA 90745-4966
(424) 558-2582
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
9500567
CA
Other
Enumeration date
04/28/2014
Last updated
04/28/2014
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