Individual
MS. MARIETA SIMPAO TAYAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10319 AZUAGA ST UNIT 301, SAN DIEGO, CA 92129-6021
(858) 504-0216
Mailing address
10319 AZUAGA ST UNIT 301, SAN DIEGO, CA 92129-6021
(858) 504-0216
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
VN227339
CA
Other
Enumeration date
02/16/2015
Last updated
02/16/2015
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