Organization
PROSPERA INTERNAL MEDICINE & AESTHETICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEA M PACE PA-C (OWNER, SECRETARY)
(619) 518-1061
Entity
Organization
Contact information
Practice address
4452 PARK BLVD STE 306, SAN DIEGO, CA 92116-4049
(619) 206-4232
(833) 972-5097
Mailing address
4452 PARK BLVD STE 306, SAN DIEGO, CA 92116-4049
(619) 206-4232
(833) 972-5097
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
05/24/2024
Last updated
05/24/2024
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