Individual
EVINA OMENGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1632 CASTAIC CT, CHULA VISTA, CA 91913-2933
(702) 985-3340
Mailing address
1632 CASTAIC CT, CHULA VISTA, CA 91913-2933
(702) 985-3340
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
787443
CA
Other
Enumeration date
06/10/2015
Last updated
06/10/2015
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