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Individual

BRENDA MARQUEZ BASAVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2778 C ST APT 8, SAN DIEGO, CA 92102-5102
(619) 807-5949
Mailing address
2778 C ST APT 8, SAN DIEGO, CA 92102-5102
(619) 807-5949

Taxonomy

Speciality
Code
Description
License number
State
246YR1600X
Registered Record Administrator
Primary

Other

Enumeration date
11/22/2019
Last updated
11/22/2019
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