Individual
NEIL ALLEN REGERO NUCUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
1802 ROCKY SHORE RD, SAN DIEGO, CA 92139-1017
(619) 434-1163
Mailing address
1802 ROCKY SHORE RD, SAN DIEGO, CA 92139-1017
(619) 434-1163
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
CA
Other
Enumeration date
05/21/2012
Last updated
05/21/2012
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