Cordova, Juan Luis

Cordova, Juan Luis is an individual health care provider with primary practice located at 1480 S Imperial Ave , El Centro CA 92243-4200. He recently has only one registered license in Other Service Providers / Driver, which is considered as his primary health care specialty. Cordova, Juan Luis can be contacted via phone (760) 455-1706.

Contact Information

Primary practice address
1480 S Imperial Ave El Centro CA 92243-4200
Phone: (760) 455-1706
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Driver 172A00000X F4704795 California

Profile Details

NPI number 1043704034
LBN Legal business name Cordova, Juan Luis
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2018
Last updated Jun 21st, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043704034 NPPES
California Other F4704795 CALIFORNIA ID

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