Individual
MR. EDWARD JOHN RONQUILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SF IDC
Contact information
Practice address
1642 HICKORY NUT PL, CHULA VISTA, CA 91915-1728
(858) 922-5269
Mailing address
1642 HICKORY NUT PL, CHULA VISTA, CA 91915-1728
(858) 922-5269
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/22/2011
Last updated
07/22/2011
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