Individual
SHANE MCGUIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FMF RECON IDC
Contact information
Practice address
200 MERCY CIRCLE, OCEANSIDE, CA 92055
(760) 725-8912
Mailing address
PO BOX 555584, CAMP PENDLETON, CA 92055-5584
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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