Individual
MRS. NERCY MANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2015 BIRCH RD, SUITE 509, CHULA VISTA, CA 91915-2002
(619) 216-0842
Mailing address
PO BOX 881144, SAN DIEGO, CA 92168-1144
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA17995
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA17995
PA LICENSE
CA
Enumeration date
04/26/2007
Last updated
07/01/2010
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