Individual
MR. CHRISTOPHER DOUGLAS KOTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
3325 SENN RD, BUILDING 55, ROOM 225, SAN DIEGO, CA 92136-5029
(619) 556-5454
Mailing address
13044 YERBA VALLEY WAY, LAKESIDE, CA 92040-1579
(817) 881-8696
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
CA
Other
Enumeration date
07/02/2007
Last updated
01/08/2008
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