Individual
GREG NICITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8868 VALENCIA ST, SPRING VALLEY, CA 91977-3339
(619) 405-3349
Mailing address
8868 VALENCIA ST, SPRING VALLEY, CA 91977-3339
(619) 405-3349
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
U5119300
CA
Other
Enumeration date
07/15/2015
Last updated
07/15/2015
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