Individual
MICHAEL THOMAS SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15034 AVENIDA MONTUOSA, APT B, SAN DIEGO, CA 92129-1442
(949) 682-6918
Mailing address
15034 AVENIDA MONTUOSA, APT B, SAN DIEGO, CA 92129-1442
(949) 682-6918
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
01/15/2014
Last updated
01/15/2014
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