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1245358530
JESUS GAYTAN ASCENCIO
MODESTO, CA
NPI
1245358530
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2007-03-26
Last Update Date
2012-10-24
Business Address
Mr. JESUS GAYTAN ASCENCIO
2215 BLUE GUM AVE
MODESTO, CA 95358-1052
Phone number: 209-525-5401
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Mailing Address
Mr. JESUS GAYTAN ASCENCIO
2118 TUCSON AVE
MODESTO, CA 95358-5944
Phone number:
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