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MR. MATTHEW NORMAN CASE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
SFIDC

Contact information

Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-0001
(619) 532-5136
Mailing address
MEDICAL READINESS DIVISION SAN, 3985 CUMMINGS RD, SAN DIEGO, CA 92136-0001
(619) 508-6622

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
1164814587
CA

Other

Enumeration date
03/20/2006
Last updated
07/21/2022
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