Individual
RICHARD BERNARD COYLE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
2496 BAUER RD, SAN DIEGO, CA 92145-7000
(858) 307-9907
(858) 307-9849
Mailing address
2496 BAUER RD, SAN DIEGO, CA 92145-0001
(858) 307-9907
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/06/2021
Last updated
09/12/2023
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