Individual
JEFFREY VELASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1240 N HARVEST WALK DR, LA PUENTE, CA 91744-2356
(626) 290-9023
Mailing address
1240 N HARVEST WALK DR, LA PUENTE, CA 91744-2356
(626) 290-9023
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
255359
CA
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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