Individual
DR. ALFRED A MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
309 3RD AVE, CHULA VISTA, CA 91910-3910
(619) 420-6030
(619) 420-9102
Mailing address
309 3RD AVE, CHULA VISTA, CA 91910-3910
(619) 420-6030
(619) 420-9102
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
29371
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000475909
UNITED COCORDIA
CA
Enumeration date
08/26/2015
Last updated
08/26/2015
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