Individual
JAIME ANTHONE ENGLEA LARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
207 W LEGION RD, BRAWLEY, CA 92227-7780
(760) 351-3288
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
20A9851
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
2OA 9851
CA
208VP0000X
Pain Medicine Physician
20A9851
CA
208VP0014X
Interventional Pain Medicine Physician
20A9851
CA
Other
Enumeration date
06/19/2008
Last updated
03/06/2015
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