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1134823487
JUAN CARLO KOONTZ
RIVERSIDE, CA
NPI
1134823487
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Former Name
JUAN CARLO PANTOJA
Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
(Licence: CA MPSS-WNVUHS)
Enumeration Date
2023-03-29
Last Update Date
2023-07-05
Business Address
JUAN CARLO KOONTZ
2085 RUSTIN AVE UNIT 2
RIVERSIDE, CA 92507-2498
Phone number: 951-955-2501
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Mailing Address
JUAN CARLO KOONTZ
200 E ALESSANDRO BLVD UNIT 44
RIVERSIDE, CA 92508-6170
Phone number: 951-419-1814
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