Individual
MR. JAIME EMMANUEL FAJARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
3126 GLENROSE AVE, ALTADENA, CA 91001-4328
(626) 296-9812
(626) 296-9818
Mailing address
901 S KINGSLEY DR, APT. 307, LOS ANGELES, CA 90006-1291
(213) 385-6005
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
236322
CA
Other
Enumeration date
01/29/2009
Last updated
01/29/2009
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