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1497220792
ANTHONY BANAAG
SAN DIEGO, CA
NPI
1497220792
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: CA 080802105)
Enumeration Date
2018-10-12
Last Update Date
2018-10-12
Business Address
ANTHONY BANAAG
2450 CRAVEN ST BLDG 3300
SAN DIEGO, CA 92136-5599
Phone number: 619-556-7931
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Mailing Address
ANTHONY BANAAG
10647 CARMEL MOUNTAIN RD
SAN DIEGO, CA 92129-2034
Phone number: 619-316-2593
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