Individual
BRENDAN DOMINGO GUERRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5617 VISTA SAN JUANICO, SAN DIEGO, CA 92154-5672
(619) 204-4905
Mailing address
5617 VISTA SAN JUANICO, SAN DIEGO, CA 92154-5672
(619) 204-4905
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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