Individual
SHAWN ERIC MCDONALD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
35000 GUADACANAL ST, SAN DIEGO, CA 92140-5599
(619) 524-8311
Mailing address
861 REBECCA DR, EL CAJON, CA 92019-3476
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710I1002X
INDEPENDENT DUTY CORPSMAN
—
Enumeration date
03/29/2006
Last updated
07/08/2007
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