Individual
ADRIANNA SELENA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDC
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-9712
Mailing address
777 6TH AVE UNIT 203, SAN DIEGO, CA 92101-7071
(616) 606-1403
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/20/2019
Last updated
06/20/2019
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