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1194504498
MARCOS ELISEO CHACON VILLANUEVA
COVINA, CA
NPI
1194504498
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TH0100X Psychologist, Health Service
(Licence: CA Cpt-02271594)
Enumeration Date
2023-09-26
Last Update Date
2023-09-26
Business Address
MARCOS ELISEO CHACON VILLANUEVA
200 E ROWLAND ST # 237
COVINA, CA 91723-3146
Phone number: 323-712-1840
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Mailing Address
MARCOS ELISEO CHACON VILLANUEVA
200 E ROWLAND ST # 237
COVINA, CA 91723-3146
Phone number: 323-712-1840
Copy
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