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Organization
MODERN MAN TRT LLC
Active
Organization
MODERN MAN TRT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HORTAREAS DO (OWNER)
(619) 356-8973
Entity
Organization
Contact information
Practice address
4306 W POINT LOMA BLVD APT D, SAN DIEGO, CA 92107-1165
(619) 356-8973
Mailing address
4306 W POINT LOMA BLVD APT D, SAN DIEGO, CA 92107-1165
(619) 356-8973
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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