Individual
ANTONETTE MALIWAT ANTONIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P
Contact information
Practice address
3851 ROSECRANS STREET, SUITE 128, SAN DIEGO, CA 92110
(619) 692-8890
Mailing address
5054 LAMBERT LANE, SAN DIEGO, CA 92115
(619) 829-5497
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
753737
CA
363L00000X
Nurse Practitioner
Primary
23320
CA
Other
Enumeration date
10/16/2013
Last updated
12/31/2015
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