Search › California › 164X00000X
Jesse Situmeang
NPI 1164166492 · on the registry since 2022 · sole proprietor
Practice
- Address
- 71952 Buena Vista Dr
29 Palms, CA 92277 - Phone
- (720) 666-0999
- Fax
- (760) 401-8212
Registry record
- Primary taxonomy
- 164X00000X
164X00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-04-22
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