Individual
GREGORIO LIEBANO RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
41945 BIG BEAR BLVD SUITE 200, BIG BEAR LAKE, CA 92315
(909) 866-5070
Mailing address
PO BOX 2471, BIG BEAR LAKE, CA 92315
(909) 866-5070
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/22/2010
Last updated
09/22/2010
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