Individual
MR. ERNEL DALEVA RAYMUNDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6236 VISTA SANTA CLARA, SAN DIEGO, CA 92154-5626
(619) 947-3694
Mailing address
6236 VISTA SANTA CLARA, SAN DIEGO, CA 92154-5626
(619) 947-3694
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
RHF 78744
CA
Other
Enumeration date
01/28/2008
Last updated
01/28/2008
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