Individual
TATIANA DE LA MORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3900 LOMALAND DR, SAN DIEGO, CA 92106-2899
(619) 849-2200
Mailing address
337 E 220TH ST, CARSON, CA 90745-3105
(310) 251-1722
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/17/2021
Last updated
03/17/2021
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