Individual
JAYVEE RONQUILLO REGALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD.
Contact information
Practice address
18460 ROSCOE BLVD, NORTHRIDGE, CA 91325-4107
(818) 837-5790
(818) 998-2506
Mailing address
PO BOX 9602, MISSION HILLS, CA 91346-9602
(818) 837-5691
(818) 792-4793
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A75727
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A757270
—
CA
Enumeration date
07/02/2006
Last updated
09/14/2021
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