Jordan Mauro Maitilasso

NPI #1366914319 in Santee, California

Provider Information

NPI Number: 1366914319
Entity Type: Individual
Name: Jordan Mauro Maitilasso
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Dec 31, 2018
Last Updated: Aug 10, 2020

Practice Location

Address: 10159 MISSION GORGE RD STE C
City: Santee
State: California
ZIP Code: 92071-3857
Phone: (619) 579-0947

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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