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General NPI Number Information
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NPI Number | 1831351972
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Entity Type | Individual
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Provider Name | MR. CARMELO SINGSON VENERACION
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Gender | Male
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 10/17/2013
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Provider Practice Location Address
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Address Line | 3350 LA JOLLA VILLAGE DR
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City | SAN DIEGO
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State | CA
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Zip | 92161-0002
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Country | US
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Telephone | 858-552-8585
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Fax |
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Provider Business Mailing Address
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Address Line | 1627 PASEO CARINA DR #2
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City | CHULA VISTA
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State | CA
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Zip | 91915
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Country | US
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Telephone | 901-379-0902
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 4544
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License Number State | TN
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