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1023640216
ENNIO ROQUE DERAS
LOS ANGELES, CA
NPI
1023640216
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2020-02-06
Last Update Date
2020-02-06
Business Address
ENNIO ROQUE DERAS
2121 W TEMPLE ST
LOS ANGELES, CA 90026-4915
Phone number: 213-385-5100
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Mailing Address
ENNIO ROQUE DERAS
2121 W TEMPLE ST
LOS ANGELES, CA 90026-4915
Phone number: 213-385-5100
Copy
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