Individual
BYRON PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
533020 BASOLINE RD, CAMP HORNO, CAMP PENDLETON, CA 92055-5402
(760) 725-7410
(760) 725-7663
Mailing address
3627 W THORNTON AVE, HEMET, CA 92545-9129
(951) 766-2798
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
CA
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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