Individual
OMAR T MANGLICMOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
619 CRESCENT DR, CHULA VISTA, CA 91911-6857
(619) 576-5088
Mailing address
619 CRESCENT DR, CHULA VISTA, CA 91911-6857
(619) 576-5088
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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