Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JUAN ANGEL GRACIANO, LVN
Active Sole ProprietorMethadone Clinic · SAN DIEGO, CA
Registration Details
- NPI Number
- 1477998136
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 7, 2013 (12.956493344154 yrs)
- Last Updated
- May 7, 2013
- License
-
269870 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3940 HOME AVESAN DIEGO, CA, 921055952Browse CA providers · Browse ZIP 92105
- Phone
- 6192628000
- Fax
- 6192667405
- Primary Specialty
-
Methadone Clinic
261QM2800X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.