Individual
LEONARDO CHAVARRIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
1809 NATIONAL AVE, SAN DIEGO, CA 92113-2113
(619) 515-2526
Mailing address
1809 NATIONAL AVE, SAN DIEGO, CA 92113-2113
(619) 515-2526
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
Other
Enumeration date
06/26/2018
Last updated
06/26/2018
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