Individual
HONEY MAE COSARE SURMILLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5555 GROSSMONT CENTER DR, LA MESA, CA 91942-3019
(619) 740-6000
Mailing address
848 SHADOW RIDGE PL, CHULA VISTA, CA 91914-2513
(206) 900-6203
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
257135
CA
Other
Enumeration date
07/11/2020
Last updated
07/11/2020
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