Individual
DR. JESUS VELASQUEZ MALLARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5483 PAPAGALLO DR, OCEANSIDE, CA 92057-1907
(760) 231-1611
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 539-9582
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301047321
FM
208000000X
Pediatrics Physician
Primary
4301047321
MI
Other
Enumeration date
12/09/2005
Last updated
01/13/2021
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