Individual
ERENIA RASTEGARPOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.V.N
Contact information
Practice address
5696 LAKE MURRAY BLVD, LA MESA, CA 91942-1929
(619) 460-7871
Mailing address
5360 MARENGO AVE APT 75, LA MESA, CA 91942-2128
(619) 779-6371
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
259206
CA
Other
Enumeration date
01/21/2015
Last updated
01/21/2015
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