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1043987803
JUAN ELIZALDE
SAN BERNARDINO, CA
NPI
1043987803
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2021-08-27
Last Update Date
2021-08-27
Business Address
JUAN ELIZALDE
3782 VERMONT ST
SAN BERNARDINO, CA 92407-6948
Phone number: 213-800-3089
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Mailing Address
JUAN ELIZALDE
17005 GRAND MAMMOTH PL
VICTORVILLE, CA 92394-7718
Phone number: 213-800-3089
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