Individual
ALVIN FONTIMAYOR CUSTODIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4647 ZION AVE, SAN DIEGO, CA 92120-2507
(833) 574-2273
Mailing address
4647 ZION AVE, SAN DIEGO, CA 92120-2507
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
42889
CA
Other
Enumeration date
08/27/2024
Last updated
05/27/2025
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