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1083259329
ANTHONY VIDAURRI AVITABILE
SAN DIEGO, CA
NPI
1083259329
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: CA 28983)
Enumeration Date
2019-11-11
Last Update Date
2019-11-11
Business Address
ANTHONY VIDAURRI AVITABILE
13223 BLACK MOUNTAIN RD # 1358
SAN DIEGO, CA 92129-2698
Phone number: 858-753-5082
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Mailing Address
ANTHONY VIDAURRI AVITABILE
13223 BLACK MOUNTAIN RD # 1358
SAN DIEGO, CA 92129-2698
Phone number: 858-753-5082
Copy
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