Individual
/PRINCE PELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6630 RIVERSIDE BLVD, SACRAMENTO, CA 95831-1938
(916) 236-8876
Mailing address
6630 RIVERSIDE BLVD, SACRAMENTO, CA 95831-1938
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN201981
CA
Other
Enumeration date
02/11/2009
Last updated
02/11/2009
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