Individual
KIMBERLY LEENIESE CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SFIDC
Contact information
Practice address
2450 CRAVEN ST, BRANCH MEDICAL CLINIC NAVAL STATION BLDG 3300, SAN DIEGO, CA 92136-5599
(619) 954-6168
(619) 556-9419
Mailing address
2450 CRAVEN ST, BRANCH MEDICAL CLINIC NAVAL STATION BLDG 3300, SAN DIEGO, CA 92136-5599
(619) 954-6168
(619) 556-9419
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
CA
Other
Enumeration date
07/06/2010
Last updated
07/06/2010
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