Individual
LARRY RAY COBURN-VILLALPANDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14272 HOOVER ST TRLR 113, WESTMINSTER, CA 92683-4325
(714) 487-1385
Mailing address
14272 HOOVER ST TRLR 113, WESTMINSTER, CA 92683-4325
(714) 487-1385
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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