Individual
MR. EDGAR M. SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
SURFACE WARFARE MEDICINE INST, 34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(619) 532-5136
Mailing address
1391 SUTTER BUTTES ST, CHULA VISTA, CA 91913-2944
(629) 532-5136
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
08/16/2010
Last updated
08/16/2010
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