Jesse Carreon, SUDRC#14462

NPI 1063261931 · on the registry since 2024 · sole proprietor

Practice

Address: 9462 Van Nuys Blvd
Panorama City, CA 91402
Phone: (818) 891-8555
Organisation at this address: Western Pacific Re-Hab
Western Pacific Med-Corp
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 37

Registry record

Primary taxonomy: 101YA0400X
101YA0400X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2024-05-14

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California