Individual
EDGAR GERARDO PAEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16552 SUNHILL DR, VICTORVILLE, CA 92395-4518
(760) 780-4400
Mailing address
16552 SUNHILL DR, VICTORVILLE, CA 92395-4518
(760) 780-4400
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
716772
CA
Other
Enumeration date
05/25/2023
Last updated
05/25/2023
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