Individual
ISAIAH SCOTT HAGOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
SURFACE WARFARE MEDICAL INSTITUTE, BUILDING 14, 34101 FARENHOLT AVE, SAN DIEGO, CA 92129
(619) 532-7968
Mailing address
8271 WAVERLY LN UNIT 67, SAN DIEGO, CA 92129-4744
(618) 210-1893
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/20/2023
Last updated
09/20/2023
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