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1194337055
JORDAN BAUTISTA GELACIO
LOS ANGELES, CA
NPI
1194337055
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-08-20
Last Update Date
2020-08-20
Business Address
JORDAN BAUTISTA GELACIO
1985 ZONAL AVE
LOS ANGELES, CA 90089-5305
Phone number: 619-947-3757
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Mailing Address
JORDAN BAUTISTA GELACIO
434 VENETO
IRVINE, CA 92614-5955
Phone number: 619-947-3757
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