Individual
PARIS MENESESBLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-6666
Mailing address
3485 OLIVE ST APT 204, LEMON GROVE, CA 91945-2263
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
12/14/2020
Last updated
12/14/2020
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