Individual
COLE THOMAS DEMOULPIED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CORPSMAN
Contact information
Practice address
2587 OLD QUARRY RD, UNIT 2232, SAN DIEGO, CA 92108
(231) 632-4574
Mailing address
2587 OLD QUARRY RD, UNIT 2232, SAN DIEGO, CA 92108
(231) 632-4574
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123456789
—
CA
05
—
D541122792699
—
DE
Enumeration date
10/01/2021
Last updated
10/01/2021
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