Individual
GLORIA TATIANA DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
32366 EVENING PRIMROSE TRL, CAMPO, CA 91906-3162
(619) 654-3389
Mailing address
32366 EVENING PRIMROSE TRL, CAMPO, CA 91906-3162
(619) 654-3389
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
05/13/2019
Last updated
05/13/2019
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