Individual
KESA MILTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1880 FAIRWAY DR, SAN LEANDRO, CA 94577-5629
(916) 729-3098
Mailing address
28650 CORK OAK LN APT 3201, HAYWARD, CA 94544-5563
(209) 815-1318
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
12/07/2020
Last updated
12/07/2020
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