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1548455405
DIANA MARIZA REVELES
CHULA VISTA, CA
NPI
1548455405
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Former Name
DIANA MARIZA MCMAHAN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA PA19306)
Enumeration Date
2007-09-12
Last Update Date
2018-03-17
Business Address
DIANA MARIZA REVELES PA
352 L ST
CHULA VISTA, CA 91911-1208
Phone number: 619-515-2325
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Mailing Address
DIANA MARIZA REVELES PA
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102-4541
Phone number: 619-515-2300
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