Individual
JEREZ JUPILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
470 S GILBUCK DR, ANAHEIM, CA 92802-1333
(714) 612-7467
Mailing address
470 S GILBUCK DR, ANAHEIM, CA 92802-1333
(714) 612-7467
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3025
CA
Other
Enumeration date
09/04/2015
Last updated
09/04/2015
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