Individual
LUIS PONCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1233 SPRINGLINE DR, PALMDALE, CA 93550-7732
(661) 266-0545
Mailing address
1233 SPRINGLINE DR, PALMDALE, CA 93550-7732
(661) 266-0545
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
03/23/2010
Last updated
03/23/2010
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