Individual
DOMEL BRIONES EVANGELISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1209 HEMLOCK WAY, SANTA ANA, CA 92707-3609
(714) 546-1966
Mailing address
1607 CALLE DEL SOL, APARTMENT H, ANAHEIM, CA 92802
(714) 563-0198
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN 226734
CA
Other
Enumeration date
05/13/2008
Last updated
05/13/2008
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