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1053799437
ONTARIO DEPREE LACEY
SAN DIEGO, CA
NPI
1053799437
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171000000X Military Health Care Provider
Enumeration Date
2015-05-18
Last Update Date
2015-05-18
Business Address
Dr. ONTARIO DEPREE LACEY M.D.
34800 BOB WILSON DR
SAN DIEGO, CA 92134-3300
Phone number: 619-532-9795
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Mailing Address
Dr. ONTARIO DEPREE LACEY M.D.
612 ARTISAN RD
THOUSAND OAKS, CA 91320-5702
Phone number: 805-953-5993
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