Individual
DOUGLAS CLAYTON MESEROLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
4309 3RD AVE, SAN DIEGO, CA 92103-1407
(619) 876-4502
Mailing address
1043 S SUNSHINE AVE APT 9, EL CAJON, CA 92020-7554
(619) 560-3196
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
216427
CA
164X00000X
Licensed Vocational Nurse
Primary
VN216427
CA
Other
Enumeration date
04/10/2018
Last updated
04/10/2018
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