Provider Information for 1932333200
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ACACIA S O'QUINN
Sex: Female
NPI: 1932333200
Last Updated: 2009-05-14
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1932333200 | ||||||||
| Enumeration Date | 2009-05-14 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1624 MISSOURI ST SAN DIEGO, CA 92109-3155 United States Phone: 707-407-6199 | Fax: | ||||||||
| Primary Practice Address | 3211 JEFFERSON ST SAN DIEGO, CA 92110-4424 United States Phone: 619-682-4012 | Fax: | ||||||||
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