GENESISJAMES BASILIO DIZON

SAN DIEGO, CA
NPI1033541966
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2013-08-01
Last Update Date2013-08-01
Business Address
Mr. GENESISJAMES BASILIO DIZON SFIDC
3167 SAINT CHARLES ST
SAN DIEGO, CA 92110-4861
Phone number: 661-370-8688
Mailing Address
Mr. GENESISJAMES BASILIO DIZON SFIDC
3167 SAINT CHARLES ST
SAN DIEGO, CA 92110-4861
Phone number: 661-370-8688
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