Individual
THOMAS CLEON JORGENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DEEP SEA DIVING IDC
Contact information
Practice address
4588 50TH ST, SAN DIEGO, CA 92115-3305
(850) 530-5141
Mailing address
4588 50TH ST, SAN DIEGO, CA 92115-3305
(850) 530-5141
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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