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1487412854
ETHAN IZU
COLTON, CA
NPI
1487412854
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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
2024-03-11
Last Update Date
2024-03-11
Business Address
ETHAN IZU
1501 VIOLET ST
COLTON, CA 92324-1603
Phone number: 949-303-0463
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Mailing Address
ETHAN IZU
1501 VIOLET ST
COLTON, CA 92324-1603
Phone number:
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