Individual
CORY FRASER MORTENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8559 CORDIAL RD, EL CAJON, CA 92021-2133
(619) 599-6136
Mailing address
8559 CORDIAL RD, EL CAJON, CA 92021-2133
(619) 599-6136
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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