MEDICARE: JUAN CARLOS ANGUIANO JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164X00000X	Licensed Vocational Nurse	737377	CA

General Provider Information

NPI Number	:	1831076173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAN CARLOS ANGUIANO JR.

Provider Business Mailing Address
First Line	:	1006 W G ST
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91762-2631
Country	:	US
Telephone Number	:	909-418-1138
Fax Number	:

Provider Business Practice Location Address
First Line	:	2277 N GAREY AVE
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91767-2330
Country	:	US
Telephone Number	:	855-252-7223
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2025
Last Update Date	:	08/19/2025

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