Provider Demographics
NPI:1346576816
Name:YORO, NIXON NICOLAS LEDINA (MEDICAL LAB TECH)
Entity Type:Individual
Prefix:MR
First Name:NIXON NICOLAS
Middle Name:LEDINA
Last Name:YORO
Suffix:
Gender:M
Credentials:MEDICAL LAB TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31608 PEPPER TREE ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:92596-8837
Mailing Address - Country:US
Mailing Address - Phone:951-926-7456
Mailing Address - Fax:
Practice Address - Street 1:31608 PEPPER TREE ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:CA
Practice Address - Zip Code:92596-8837
Practice Address - Country:US
Practice Address - Phone:951-926-7456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
62955246RM2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory