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1043921711
SANQUELA DEONA GRESHAM
SAN DIEGO, CA
NPI
1043921711
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2022-12-13
Last Update Date
2023-05-25
Business Address
SANQUELA DEONA GRESHAM IDC
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134-7000
Phone number: 706-990-9926
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Mailing Address
SANQUELA DEONA GRESHAM IDC
5264 BEACHFRONT COVE ST UNIT 217
SAN DIEGO, CA 92154-5251
Phone number: 706-990-9926
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