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Individual

CHARLIE SUASTEGUI MOLINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
921 S 1ST ST, SAN JOSE, CA 95110-3126
(408) 938-6731
(408) 283-6152
Mailing address
2625 ZANKER RD, SAN JOSE, CA 95134-2130
(408) 325-5105
(408) 944-0275

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
07/16/2018
Last updated
07/16/2018
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