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Individual

ESTRELLITA DELROSAR EDMOND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
I.D.C

Contact information

Practice address
2450 CRAVEN ST, SAN DIEGO, CA 92136
(619) 556-8114
(619) 556-8109
Mailing address
2450 CRAVEN ST, SAN DIEGO, CA 92136-5599
(619) 556-0000
(619) 556-8109

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
CA

Other

Enumeration date
10/08/2008
Last updated
05/16/2018
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