Individual
KEVIN NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SFIDC
Contact information
Practice address
34101 FARENHOLT AVE, BLDG 14, SAN DIEGO, CA 92134-5291
(408) 802-4111
Mailing address
34101 FARENHOLT AVE, BLDG 14, SAN DIEGO, CA 92134-5291
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
01/14/2014
Last updated
01/14/2014
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