Individual
MR. PORFIRIO NINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
805 BEYER WAY, SAN DIEGO, CA 92154-2259
(619) 857-4461
Mailing address
805 BEYER WAY, SAN DIEGO, CA 92154-2259
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
02/18/2011
Last updated
02/18/2011
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