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Individual

MICHELLE MARISOL DIAZ LEON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1168 CYPRESS AVE, IMPERIAL BEACH, CA 91932-1664
(551) 262-3331
Mailing address
1168 CYPRESS AVE, IMPERIAL BEACH, CA 91932-1664

Taxonomy

Speciality
Code
Description
License number
State
374700000X
Technician
Primary

Other

Enumeration date
04/28/2023
Last updated
04/28/2023
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