Individual
DANIEL CARRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SFIDC
Contact information
Practice address
2645 W CANYON AVE APT 450, SAN DIEGO, CA 92123-4700
(630) 212-3269
Mailing address
2645 W CANYON AVE APT 450, SAN DIEGO, CA 92123-4700
(630) 212-3269
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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