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Individual

MR. JACK OLIVER BRAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RRT

Contact information

Practice address
3350 LA JOLLA VILLAGE DR, SAN DIEGO, CA 92161-0002
(858) 552-8585
Mailing address
837 10TH ST, IMPERIAL BEACH, CA 91932-2217
(619) 423-2429

Taxonomy

Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
31046
CA

Other

Enumeration date
03/09/2011
Last updated
03/09/2011
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