Individual
RALPH KEVIN ROQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
614 W MANCHESTER BLVD, INGLEWOOD, CA 90301, 104, INGLEWOOD, CA 90301
(310) 412-0879
Mailing address
7246 REMMET AVE, CANOGA PARK, CA 91303-1531
(818) 206-0360
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
279433
CA
Other
Enumeration date
02/21/2020
Last updated
02/21/2020
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