Individual
VIRGILIO FRANCISCO COLOSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSO
Contact information
Practice address
1745 THOMPSON AVE, CHULA VISTA, CA 91913-4338
(619) 621-0641
Mailing address
1745 THOMPSON AVE, CHULA VISTA, CA 91913-4338
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/07/2019
Last updated
05/07/2019
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