Individual
DR. DESTY ALCANCIA MANZO-CHUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1201 CAMINO LORADO, 1201 CAMINO LORADO, SAN MARCOS, CA 92078-7106
(760) 744-4535
Mailing address
1201 CAMINO LORADO, SAN MARCOS, CA 92078
(760) 744-4535
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1268
SD
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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