Healthcare Provider Details

I. General information

NPI: 1851717417
Provider Name (Legal Business Name): OPERADORA JOBARA SA DE CV
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2014
Last Update Date: 03/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MANUEL M DIEGUEZ NO. 360 COL. EMILIANO ZAPATA
PUERTO VALLARTA JALISCO
48380
MX

IV. Provider business mailing address

MANUEL M DIEGUEZ NO. 360 COL. EMILIANO ZAPATA
PUERTO VALLARTA JALISCO
48380
MX

V. Phone/Fax

Practice location:
  • Phone: 322-223-0656
  • Fax:
Mailing address:
  • Phone: 322-223-0656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberC6867002
License Number StateZZ

VIII. Authorized Official

Name: MR. HECTOR ALONSO MORA GARCIA
Title or Position: OWNER
Credential: QFB
Phone: 322-223-0656