MEDICARE: CHARLYN OSOTEO CELZO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	839359	CA

General Provider Information

NPI Number	:	1366005241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLYN OSOTEO CELZO

Provider Business Mailing Address
First Line	:	8555 PARKBROOK ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92114-7737
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2425 HOOVER AVE
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-6619
Country	:	US
Telephone Number	:	619-267-8400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2019
Last Update Date	:	04/17/2019

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Directions to “ CHARLYN OSOTEO CELZO ” Practice Location

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