Individual
MICHAEL S JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
754 RAMBUR ST, CHULA VISTA, CA 91911-6929
(619) 572-8323
Mailing address
754 RAMBUR ST, CHULA VISTA, CA 91911-6929
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
CA
Other
Enumeration date
02/23/2007
Last updated
07/26/2007
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