Individual
MR. HERMIN ALEX ACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(619) 532-6195
Mailing address
830 CERRISSA ST, SAN DIEGO, CA 92154-1207
(210) 313-7186
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/24/2013
Last updated
07/24/2013
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