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1003206970
IVANOVA GUILLEN
SAN DIEGO, CA
NPI
1003206970
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: CA AT10270)
Enumeration Date
2015-01-30
Last Update Date
2015-01-30
Business Address
IVANOVA GUILLEN PTA
9089 CLAIREMONT MESA BLVD SUITE 200
SAN DIEGO, CA 92123-1234
Phone number: 800-787-6787
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Mailing Address
IVANOVA GUILLEN PTA
3541 VALLEY RD APT 3
BONITA, CA 91902-4161
Phone number: 626-261-3941
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