Individual
MR. MAURICE KIM TANJUAQUIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
3913 INGRAHAM ST APT U309, SAN DIEGO, CA 92109-5918
(619) 518-4329
Mailing address
3913 INGRAHAM ST APT U309, SAN DIEGO, CA 92109-5918
(619) 518-4329
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
CA
Other
Enumeration date
07/31/2013
Last updated
07/31/2013
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