Individual
WILLIAM DOMINGO HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
1ST BATTALION 4TH MARINES BATTALION AIDE STATION, CAMP PENDLETON, CA 92055-5380
(760) 763-1412
Mailing address
3137 TAUSSIG ST, SAN DIEGO, CA 92124-3648
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/02/2008
Last updated
04/02/2008
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