Individual
AUGUSTIN RUCOBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3851 ROSECRANS ST, SAN DIEGO, CA 92110-3115
(619) 692-5565
Mailing address
5066 MERRIMAC CT, SAN DIEGO, CA 92117-1001
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95096279
CA
163WC1500X
Community Health Registered Nurse
552937
CA
Other
Enumeration date
06/13/2018
Last updated
06/13/2018
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