Individual
ANTONIO RIVERA ESTRADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
734 10TH AVE, SAN DIEGO, CA 92101-6502
(619) 239-4663
Mailing address
734 10TH AVE, SAN DIEGO, CA 92101-6502
(619) 239-4663
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
282088
CA
Other
Enumeration date
08/14/2015
Last updated
08/14/2015
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