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Individual

MRS. ALBA NIDIA CASCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NURSE PRACTITIONER

Contact information

Practice address
251 LANDIS AVE, CHULA VISTA, CA 91910-2628
(619) 515-2500
Mailing address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 515-2300

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
95001957
CA
363LF0000X
Family Nurse Practitioner
Primary
95001957
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95001957
MEDICAL LIC
CA
Enumeration date
03/03/2015
Last updated
11/11/2024
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