Individual
CORINA BALTAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
290 IOOF AVE, GILROY, CA 95020-5204
(408) 887-4803
Mailing address
290 IOOF AVE, GILROY, CA 95020-5204
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/09/2022
Last updated
05/09/2022
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