Individual
MR. NEIL JETRHO SOBREVINAS MERCADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSN, RN
Contact information
Practice address
1417 ONEONTA KNL, SOUTH PASADENA, CA 91030-4611
(650) 863-4586
Mailing address
1417 ONEONTA KNL, SOUTH PASADENA, CA 91030-4611
(650) 863-4586
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95136514
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95002685
CA
Other
Enumeration date
07/24/2024
Last updated
09/03/2025
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