Individual
MARK PHILIP LITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SOIDC
Contact information
Practice address
1ST RECON BAS BLDG 33308, CAMP PENDLETON, CA 92055
(760) 725-8912
Mailing address
2205 CRESTLINE DR, OCEANSIDE, CA 92054-3611
(619) 665-7908
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
03/28/2012
Last updated
03/28/2012
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