Most Relevant Information
Provider Data
| NPI Number: | 1003550781 |
| Provider Name: | PAUL WESLEY CANTOS NOVAL LPT/LVN |
| Entity Type: | Individual |
| Taxonomy Code: | 164X00000X |
| Specialty: | Licensed Vocational Nurse |
| License Number: | 253780 |
Most Important Dates
| Enumeration Date: | 04/27/2022 |
| Last Updated: | 04/27/2022 |
Provider Practice Location
768 PLEASANT VALLEY RD
DIAMOND SPRINGS
CA
956199260
Practice Location Phone/Fax
| Phone: | 5306216290 |
| Fax: |
Provider Mailing Location
768 PLEASANT VALLEY RD
DIAMOND SPRINGS
CA
956199260
Provider Mailing Phone/Fax
| Phone: | 5306216290 |
| Fax: |