Organization
JUAN C CIFUENTES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUAN CARLOS CIFUENTES (OWNER)
(818) 760-2461
Entity
Organization
Contact information
Practice address
10938 VANOWEN ST, NORTH HOLLYWOOD, CA 91605-6426
(818) 760-2461
(818) 760-1105
Mailing address
10938 VANOWEN ST, NORTH HOLLYWOOD, CA 91605-6426
(818) 760-2461
(818) 760-1105
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
5457080001
CA
Other
Enumeration date
11/01/2006
Last updated
01/06/2012
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