Individual
MR. RODEN ROSARIO QUIBUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
35000 GUADALCANAL ST, SAN DIEGO, CA 92140-5599
(619) 524-1963
(619) 532-9510
Mailing address
35000 GUADALCANAL ST, SAN DIEGO, CA 92140-5599
(619) 524-1963
(619) 524-8072
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
1151164
CA
1710I1002X
Independent Duty Corpsman
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/15/2007
Last updated
02/23/2021
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