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1053167668
JOSE LUIS CONDOR
SACRAMENTO, CA
NPI
1053167668
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-04-25
Last Update Date
2024-04-25
Business Address
JOSE LUIS CONDOR
4610 X ST
SACRAMENTO, CA 95817-2200
Phone number: 562-489-6122
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Mailing Address
JOSE LUIS CONDOR
3116 2ND AVE APT C
SACRAMENTO, CA 95817-2759
Phone number: 562-489-6122
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