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1265986814
BENNIE BACA
CERES, CA
NPI
1265986814
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
164X00000X Licensed Vocational Nurse
(Licence: CA VN186764)
Enumeration Date
2016-08-12
Last Update Date
2016-09-08
Business Address
Mr. BENNIE BACA LVN
1904 RICHLAND AVE
CERES, CA 95307-4562
Phone number: 209-312-7057
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Mailing Address
Mr. BENNIE BACA LVN
1904 RICHLAND AVE
CERES, CA 95307
Phone number: 209-312-7057
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