Individual
MRS. DEVERY MANDAGIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN PHN
Contact information
Practice address
3851 ROSECRANS ST, SAN DIEGO, CA 92110-3115
(619) 692-8610
Mailing address
2405 CHICAGO ST, SAN DIEGO, CA 92110-4106
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
556258
CA
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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