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1326690835
LUIS GUILLERMO BANUELOS
INDIO, CA
NPI
1326690835
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2019-07-15
Last Update Date
2022-04-27
Business Address
LUIS GUILLERMO BANUELOS
44199 MONROE ST
INDIO, CA 92201-3096
Phone number: 760-770-2286
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Mailing Address
LUIS GUILLERMO BANUELOS
44199 MONROE ST
INDIO, CA 92201-3096
Phone number: 760-770-2286
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