Individual
DEREK MATEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1201 34TH ST, SAN DIEGO, CA 92102-2416
(619) 232-2946
Mailing address
11982 DAPPLE WAY, SAN DIEGO, CA 92128-5245
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
01/22/2019
Last updated
01/22/2019
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