Individual
JOSE BELTRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
474 LOGAN WAY, MARINA, CA 93933-5204
(831) 512-6291
Mailing address
474 LOGAN WAY, MARINA, CA 93933-5204
(831) 512-6291
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
F7877188
CA
172A00000X
Driver
Primary
—
—
Other
Enumeration date
05/20/2022
Last updated
05/20/2022
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