Individual
CASSANDRA BAGNALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3737 MORAGA AVE STE A204, SAN DIEGO, CA 92117-5489
(858) 352-6438
(760) 818-8025
Mailing address
4478 UTAH ST APT 6, SAN DIEGO, CA 92116-5115
(704) 807-1105
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
L9507
CA
Other
Enumeration date
07/20/2023
Last updated
07/20/2023
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