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DR. MIGUEL AMEZCUA DO
>> Organized Health Care Education/Training Program >> StudentRegistrant NPI Number: 1740773787
Individual Registrant:DR. MIGUEL AMEZCUA DO
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
26520 CACTUS AVE MORENO VALLEY, CA 92555-3927 US
Tel: 951-486-4753 Fax: --
Tel: 951-486-4753 Fax: --
Contact information for business:
26520 CACTUS AVE MORENO VALLEY, CA 92555-3927 US
Tel: 951-486-4753 Fax: --
Tel: 951-486-4753 Fax: --
Registration Information:
NPI: 1740773787
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 390200000X | Student Organized Health Care Education/Training Program |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
