Individual
HERIBERTO LARA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
800 SANTA FE DR, ENCINITAS, CA 92024-3841
(760) 753-1121
Mailing address
800 SANTA FE DR, ENCINITAS, CA 92024-3841
(760) 753-1121
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000011041
CA
Other
Enumeration date
01/08/2015
Last updated
01/08/2015
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