Individual
SIMON PEDRO TRUJILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
85 SANDPIPER AVE, SAN CLEMENTE, CA 92672-2616
(469) 734-1658
Mailing address
85 SANDPIPER AVE, SAN CLEMENTE, CA 92672-2616
(469) 734-1658
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/04/2020
Last updated
06/04/2020
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