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1790134542
JEANNA MAE CASTRO
SAN DIEGO, CA
NPI
1790134542
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
302R00000X Health Maintenance Organization
(Licence: CA 472887029)
Enumeration Date
2016-06-11
Last Update Date
2016-06-11
Business Address
-- JEANNA MAE CASTRO
3609 4TH AVE
SAN DIEGO, CA 92103-4105
Phone number: 619-255-0789
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Mailing Address
-- JEANNA MAE CASTRO
3609 4TH AVE
SAN DIEGO, CA 92103-4105
Phone number: 619-255-0789
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