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1265776868
TED CASILLAN GUTIERREZ
SAN DIEGO, CA
NPI
1265776868
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider Independent Duty Corpsman
Enumeration Date
2012-11-20
Last Update Date
2012-11-20
Business Address
TED CASILLAN GUTIERREZ
10226 BORDELON ST
SAN DIEGO, CA 92124-3207
Phone number: 858-790-1088
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Mailing Address
TED CASILLAN GUTIERREZ
10226 BORDELON ST
SAN DIEGO, CA 92124-3207
Phone number: 858-790-1088
Copy
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