GARRY ROGER DORMEVIL

LA QUINTA, CA
NPI1164196457
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: VA  0024180743)
Enumeration Date2021-08-02
Last Update Date2022-04-07
Business Address
GARRY ROGER DORMEVIL nurse practitioner
79440 CORPORATE CENTER DR STE 100
LA QUINTA, CA 92253-7243
Phone number: 805-719-3700
Mailing Address
GARRY ROGER DORMEVIL nurse practitioner
135 S STATE COLLEGE BLVD STE 350
BREA, CA 92821-5814
Phone number: 805-719-3700