Individual
ANTHONY J DEAK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
11738 GOLDEN CIR, LAKESIDE, CA 92040-5322
(619) 277-6776
Mailing address
11738 GOLDEN CIR, LAKESIDE, CA 92040-5322
(619) 277-6776
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/22/2011
Last updated
07/22/2011
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