Individual
MR. GERRY B HORTILLOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2180 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4513
(805) 788-2524
(805) 788-2056
Mailing address
2180 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4513
(805) 788-2524
(805) 788-2056
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/13/2010
Last updated
08/13/2010
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