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Individual

MS. VICKI A MAIERLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PERMANENT MAKE UP AR

Contact information

Practice address
9834 GENESEE AVE, SUITE 128, LA JOLLA, CA 92037-1223
(619) 368-6269
(858) 457-0669
Mailing address
3970 NOBEL DR, #102, SAN DIEGO, CA 92122-5789
(619) 368-6269
(858) 457-0669

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Enumeration date
10/12/2009
Last updated
10/12/2009
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