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1780296905
GUSTAVO FONSECA
SAN DIEGO, CA
NPI
1780296905
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: CA 95042131)
Enumeration Date
2020-08-19
Last Update Date
2020-08-19
Business Address
GUSTAVO FONSECA RN
4309 3RD AVE
SAN DIEGO, CA 92103-1407
Phone number: 619-876-4502
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Mailing Address
GUSTAVO FONSECA RN
3905 MAIN ST
CHULA VISTA, CA 91911-6213
Phone number:
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