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Carly Dvorak

Student in an Organized Health Care Education/Training Program in San Diego, CA. Individual provider (NPI-1).

NPI number1104715481
StatusActive
Last updated in NPPESJul 1, 2025

Details

NPI
1104715481
Entity type
Individual (NPI-1)
Name
Carly Dvorak
Sex
Female
Sole proprietor
No
Enumeration date
Jul 1, 2025
Certification date
Jul 1, 2025
Last updated
Jul 1, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

9055 Balboa Ave
San Diego, CA 92123-1509

Phone 619-849-3331

Mailing address

9055 Balboa Ave
San Diego, CA 92123-1509

Phone 619-849-3331

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