Larry Allen Jean

NPI 1790127728 - Community Health Worker - 172V00000X

NPI Details
NPI 1790127728
Gender Male
Enumeration Date 07/18/2013
Last Updated 07/18/2013
Entity Type Individual
Active Over 3 years ago
Practice Location
3230 KERNER BLVD
SAN RAFAEL CA, 94901-4840, US
Phone (415) 847-3209
Fax
Business Location
36D OLIVA DR
NOVATO CA, 94947-2123, US
Phone (415) 450-0105
Fax
Toxanomy
Taxonomy Code 172V00000X
License State
License Number
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According to our database, Larry Allen Jean NPI is 1790127728, taxonomy code is 172V00000X Larry Allen Jean physically located at 3230 Kerner Blvd, San Rafael CA, 94901-4840. NPI Number Larry Allen Jean has the Individual type.

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1790127728 NPI number is provided on an as is basis without warranty of any kind. 1790127728 is maintained by the National Plan & Provider Enumeration System. The contents of Larry Allen Jean are for informational purposes only.