Individual
DAISY RUTH POMILIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6154 MISSION GORGE RD, 120, SAN DIEGO, CA 92120-3493
(619) 285-1718
Mailing address
1849 K AVE, NATIONAL CITY, CA 91950-5908
(619) 474-2390
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
370069MN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37AL
—
CA
Enumeration date
04/11/2008
Last updated
04/11/2008
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