Individual
JESUS GUADALUPE LANDEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8112 CYPRESS AVE, SOUTH GATE, CA 90280-2203
(323) 536-4749
Mailing address
8112 CYPRESS AVE, SOUTH GATE, CA 90280-2203
(323) 536-4749
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5783
CA
Other
Enumeration date
05/23/2022
Last updated
05/23/2022
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