Individual
CARLOS HUMBERTO MURCIA I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1701 SLATER ST, SANTA ROSA, CA 95404-2816
(707) 321-4809
Mailing address
1701 SLATER ST, SANTA ROSA, CA 95404-2816
(707) 321-4809
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
Primary
339359
—
136A00000X
Registered Dietetic Technician
86291705
—
Other
Enumeration date
06/13/2021
Last updated
06/13/2021
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