TED CASILLAN GUTIERREZ

SAN DIEGO, CA
NPI1265776868
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2012-11-20
Last Update Date2012-11-20
Business Address
-- TED CASILLAN GUTIERREZ
10226 BORDELON ST
SAN DIEGO, CA 92124-3207
Phone number: 858-790-1088
Mailing Address
-- TED CASILLAN GUTIERREZ
10226 BORDELON ST
SAN DIEGO, CA 92124-3207
Phone number: 858-790-1088
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