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1225177926
TRACY FULLENWIDER SANTOS
SAN DIEGO, CA
NPI
1225177926
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: CA 20A8330)
Enumeration Date
2007-02-06
Last Update Date
2021-11-29
Business Address
TRACY FULLENWIDER SANTOS DO
4647 ZION AVE
SAN DIEGO, CA 92120-2507
Phone number: 619-528-5000
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Mailing Address
TRACY FULLENWIDER SANTOS DO
4647 ZION AVE
SAN DIEGO, CA 92120-2507
Phone number: 619-528-5000
Copy
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