Individual
ALLAN NELSON GANUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
34800 BOB WILSON DR, NAVAL MEDICAL CENTER SAN DIEGO, SAN DIEGO, CA 92134-0001
(619) 532-6400
Mailing address
406 E. PALMER AVE APT 10, GLENDALE, CA 91205
(818) 667-3547
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
03/31/2017
Last updated
03/31/2017
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