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General NPI Number Information
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NPI Number | 1518865120
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Entity Type | Individual
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Provider Name | JONATHAN STEVE VALLADARES AYALA
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Gender | Male
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Dates
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Enumeration Date | 10/26/2026
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Last Update Date | 10/26/2026
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Provider Practice Location Address
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Address Line | 2035 CAMFIELD AVE
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City | COMMERCE
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State | CA
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Zip | 90040-1501
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Country | US
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Telephone | 323-767-0250
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Fax |
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Provider Business Mailing Address
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Address Line | 9231 VICTORIA AVE
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City | SOUTH GATE
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State | CA
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Zip | 90280-4423
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Country | US
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Telephone | 323-346-2147
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | VN763613
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License Number State | CA
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