Individual
BENEDICTO VICENCIO MANALANSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SFIDC
Contact information
Practice address
2240 SPRING OAK WAY, SAN DIEGO, CA 92139-3922
(619) 475-1100
Mailing address
2240 SPRING OAK WAY, SAN DIEGO, CA 92139-3922
(619) 475-1100
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/27/2008
Last updated
05/27/2008
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