Individual
WILL DELAVEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3853 ROSECRANS ST, SAN DIEGO, CA 92110-3115
(619) 692-8224
Mailing address
1963 OLIVE AVE, SAN DIEGO, CA 92139-1627
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
00527140
CA
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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