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Individual

MR. BRUCE PARKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LVN

Contact information

Practice address
600 B ST, 1580, SAN DIEGO, CA 92101-4520
(619) 916-0439
Mailing address
600 B ST, 1580, SAN DIEGO, CA 92101-4520
(619) 916-0439

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
194917
CA

Other

Enumeration date
09/04/2007
Last updated
09/04/2007
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