Individual
MS. SUSAN DENISE REGANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9708 CARAWAY ST, LAKESIDE, CA 92040-4272
(619) 792-0581
Mailing address
9708 CARAWAY ST, LAKESIDE, CA 92040-4272
(619) 792-0581
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
SLD1983
CA
Other
Enumeration date
04/23/2024
Last updated
04/23/2024
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