Individual
JASON FOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
34101 FARENHOLT AVE, BUILDING 14, SAN DIEGO, CA 92134-0001
(619) 532-7968
Mailing address
34101 FARENHOLT AVE, BUILDING 14, SAN DIEGO, CA 92134-0001
(619) 532-7968
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/07/2015
Last updated
04/07/2015
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