Individual
RICARDO ANDRES CHANES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
3860 HAINES ST APT K, SAN DIEGO, CA 92109-6362
(949) 933-0336
Mailing address
3860 HAINES ST APT K, SAN DIEGO, CA 92109-6362
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/09/2016
Last updated
05/09/2016
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