JASON LEE GALLEGUILLOS

SAN DIEGO, CA
NPI1134473820
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2012-11-01
Last Update Date2012-11-03
Business Address
Mr. JASON LEE GALLEGUILLOS IDC
2917 C ST UNIT 187
SAN DIEGO, CA 92102-2296
Phone number: 760-208-8939
Mailing Address
Mr. JASON LEE GALLEGUILLOS IDC
2917 C ST UNIT 187
SAN DIEGO, CA 92102-2296
Phone number: 760-208-8939