Individual
JAVIER MAYORGA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
66 HURLBUT ST, PASADENA, CA 91105-4025
(626) 441-4221
Mailing address
2128 GLENROSE AVE, ALTADENA, CA 91001-5528
(626) 253-2767
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
277784
CA
Other
Enumeration date
09/13/2015
Last updated
09/13/2015
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