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NPI 1114064920

IndividualActive

Abel Lara

NPI 1114064920 · Independent Duty Corpsman · San Diego, CA

Provider details

NPI number: 1114064920
Entity type: Individual
Primary specialty: Independent Duty CorpsmanOther Service Providers
Sex: Male
Sole proprietor: Yes
License: B1581660 (CA)

Practice location

2710 N Harbor Dr

San Diego, CA 92101-1028

Phone: (619) 278-7130

Fax: (619) 278-7132

More CA providers

Mailing address

2710 N Harbor Dr

San Diego, CA 92101-1028

Registry dates

Enumerated: 2007-01-31
Last updated: 2025-09-11

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Abel Lara — NPI 1114064920, San Diego, CA | NPI Central