Individual
LIBERTY THI AWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
367 N MAGNOLIA AVE, EL CAJON, CA 92020-3995
(619) 441-6500
Mailing address
2860 COMSTOCK ST, SAN DIEGO, CA 92111-5506
(619) 792-7867
Taxonomy
Speciality
Code
Description
License number
State
364SC1501X
Community Health/Public Health Clinical Nurse Specialist
Primary
95147345
CA
Other
Enumeration date
10/30/2018
Last updated
10/30/2018
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