Luis Alberto Anzures

Individual provider Active NPI Independent Duty Corpsman · San Diego, CA

NPI 1720640972 · NPPES record last updated Jul 8, 2019

Key facts

NPI
1720640972
Entity type
Individual (NPI type 1)
Primary specialty
Independent Duty Corpsman 1710I1002X
Practice address
34101 Farenholt Ave
San Diego, CA 92134-7000
Phone
(619) 532-7968
NPI assigned
Jul 8, 2019
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Yes

Addresses

Primary practice location

34101 Farenholt Ave
San Diego, CA 92134-7000

Mailing address

34101 Farenholt Ave
San Diego, CA 92134-7000
Phone (619) 532-7968

Other identifiers

IdentifierTypeStateIssuer
97869786OtherCAIDC

Electronic endpoints

TypeEndpointUseAffiliation
Other URL luis.a.anzures.mil@mail.mil
Other URL luis.a.anzures.mil@mail.mil

Other providers in San Diego, CA

All providers in San Diego, CA · Independent Duty Corpsman in California

Sources for this page

Verify at the official NPI Registry.