Individual
WALTER JAVIER DESPRADEL QUINTANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MILITARY PROVIDER
Contact information
Practice address
840 17TH ST APT 117, SAN DIEGO, CA 92101-6655
(619) 642-7162
Mailing address
840 17TH ST APT 117, SAN DIEGO, CA 92101-6655
(619) 642-7162
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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