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General NPI Number Information
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NPI Number | 1902147770
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Entity Type | Organization
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Legal Business Name | EL MASPURO INVESTMENT ENTERPRISES, INC
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Dates
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Enumeration Date | 03/04/2013
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Last Update Date | 03/04/2013
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Provider Practice Location Address
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Address Line | 19325 E SWANEE LN
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City | COVINA
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State | CA
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Zip | 91723-3257
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Country | US
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Telephone | 626-646-9072
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Fax | 626-332-1551
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Provider Business Mailing Address
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Address Line | 19325 E SWANEE LN
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City | COVINA
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State | CA
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Zip | 91723-3257
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Country | US
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Telephone | 626-646-9072
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Fax | 626-332-1551
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Authorized Official
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Title or Position | CHEIF EXECUTIVE OFFICER
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Name | JOSEPH WEIGEL
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Credential | NP
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Telephone | 626-646-9072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 16725
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License Number State | CA
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