Individual
MR. JURES DECOLONGON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14445 OLIVE VIEW DR, SYLMAR, CA 91342-1437
(747) 210-3125
Mailing address
14445 OLIVE VIEW DR, SYLMAR, CA 91342-1437
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
521518
CA
Other
Enumeration date
06/26/2017
Last updated
06/26/2017
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