Individual
BRIAN GEORGE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(760) 419-0943
Mailing address
1140 AMADOR AVE, VISTA, CA 92083-5620
(760) 419-0943
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/06/2020
Last updated
04/06/2020
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