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Mr. Lavonderick Lavar Campbell SR.
Student in an Organized Health Care Education/Training Program in San Diego, California
NPI 1497519532

Lavonderick Lavar Campbell SR. is a Student in an Organized Health Care Education/Training Program based in San Diego, CA. Lavonderick Lavar Campbell SR. practices in San Diego, CA. The NPI Number for Lavonderick Lavar Campbell SR. is 1497519532 and holds a License No. (California).

The current practice location address for Lavonderick Lavar Campbell SR. is 2865 Logan Ave, San Diego, CA and can be reached out via phone at 619-232-4357.

Location: 2865 Logan Ave, San Diego, CA, 92113-2411
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1497519532
Provider Name
Lavonderick Lavar Campbell SR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
2865 Logan Ave, San Diego, CA, 92113-2411
Phone Number
619-232-4357
Fax Number
Provider Enumeration Date
02/08/2024
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2865 Logan Ave
City
San Diego
State
California
Zip
92113-2411
Phone Number
619-232-4357
Fax Number
person
Provider Business Mailing Address Details
Address
2865 Logan Ave
City
San Diego
State
California
Zip
92113-2411
Phone Number
619-232-4357
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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