Individual
MR. MICHAEL LEENARD SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
8266 STATION VILLAGE LN APT 2601, SAN DIEGO, CA 92108-5590
(336) 477-4274
Mailing address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
08/12/2014
Last updated
08/12/2014
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