Individual
BENITO MANGROBANG CALIBOSO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
330 SAN MARINO AVE, VALLEJO, CA 94589-2656
(707) 557-6210
Mailing address
330 SAN MARINO AVE, VALLEJO, CA 94589-2656
(707) 557-6210
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
03/23/2010
Last updated
04/19/2011
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