Individual
IMELDA SAN DIEGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 B ST, SAN DIEGO, CA 92101-4520
(619) 615-0439
Mailing address
600 B ST, SAN DIEGO, CA 92101-4520
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
711175
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71175
RN
CA
Enumeration date
04/02/2008
Last updated
04/02/2008
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