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Individual

CARLETUS M PATRICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
2450 CRAVEN ST, SAN DIEGO, CA 92136-5599
(619) 556-6081
Mailing address
1616 SAN BERNARDINO AVE, SPRING VALLEY, CA 91977-4650
(619) 694-9040

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
02/05/2008
Last updated
09/06/2011
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