Individual
MR. PEDRO BOJORQUEZ SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3245 UNIVERSITY AVE, SUITE 543, SAN DIEGO, CA 92104-2009
(619) 255-7725
(619) 255-7718
Mailing address
3245 UNIVERSITY AVE, SUITE 543, SAN DIEGO, CA 92104-2009
(619) 255-7725
(619) 255-7718
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
24026338
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201208961
INDIVIDUAL TAXPAYER IDENTIFICATION NUMBER
CA
Enumeration date
05/17/2011
Last updated
09/14/2015
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