Individual
MR. DOMINGO PONTEJOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 B ST, SAN DIEGO, CA 92101-4501
(619) 615-3197
Mailing address
7230 ZEST ST, SAN DIEGO, CA 92139-1252
(619) 763-8822
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
00848703
CA
Other
Enumeration date
03/24/2017
Last updated
03/24/2017
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