Individual
GLYNN CONCEPCION CASCOLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
1485 GRAEBER ST, BLDG 2300, MARCH AIR RESERVE BASE, CA 92518-1728
(951) 655-2773
Mailing address
1485 GRAEBER ST, BLDG 2300, MARCH AIR RESERVE BASE, CA 92518-1728
(951) 655-2773
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
481112
CA
163WP0808X
Psychiatric/Mental Health Registered Nurse
481112
CA
Other
Enumeration date
04/15/2012
Last updated
04/15/2012
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