Individual
MRS. CAROLE LINE ALTINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2828 W CANYON AVE, SAN DIEGO, CA 92123-4648
(619) 301-9041
Mailing address
2828 W CANYON AVE, SAN DIEGO, CA 92123-4648
(619) 301-9041
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
77920
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0020309390
KAISER PERMANENTE
CA
Enumeration date
11/27/2019
Last updated
11/27/2019
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