Individual
GAVIN DE JULIO RIESER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3780 MASSACHUSETTS AVE, LA MESA, CA 91941-7638
(619) 465-1313
Mailing address
6180 AGEE ST UNIT 173, SAN DIEGO, CA 92122-3615
(916) 396-8095
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95263200
CA
Other
Enumeration date
04/17/2023
Last updated
04/17/2023
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