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Individual

LUIS SERVANO TEOXON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP-C

Contact information

Practice address
11750 STERLING AVE STE C, RIVERSIDE, CA 92503
(951) 637-8752
Mailing address
3420 COUNCIL ST APT 102, LOS ANGELES, CA 90004-3629
(213) 386-0654

Taxonomy

Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
22969
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F1212085
AANP CERTIFICATION
TX
Enumeration date
12/26/2013
Last updated
12/26/2013
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