Individual
CELSO VILLANUEVA CAYANAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2051 CUSHING RD, SAN DIEGO, CA 92106-6173
(619) 524-5733
Mailing address
2051 CUSHING ROAD, FPO, AP 92106
(619) 524-5733
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
00000000000000000000
CA
Other
Enumeration date
01/17/2013
Last updated
01/17/2013
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