Individual
JESUS RICARDO PUGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
824 HOLLISTER ST UNIT A, SAN DIEGO, CA 92154-1334
(619) 721-7509
Mailing address
824 HOLLISTER ST UNIT A, SAN DIEGO, CA 92154-1334
(619) 721-7509
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
A6557157
CA
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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