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1649745282
JESUS EFREN VITAL
PANORAMA CITY, CA
NPI
1649745282
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 5565)
Enumeration Date
2018-10-10
Last Update Date
2018-10-10
Business Address
JESUS EFREN VITAL
9140 VAN NUYS BLVD STE 211
PANORAMA CITY, CA 91402-6764
Phone number: 818-895-2206
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Mailing Address
JESUS EFREN VITAL
9140 VAN NUYS BLVD STE 211
PANORAMA CITY, CA 91402-6764
Phone number: 818-895-2206
Copy
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