Individual
BRADFORD JOSHUA ALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DEEP SEA IDC
Contact information
Practice address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(309) 781-9399
Mailing address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(309) 781-9399
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/29/2018
Last updated
06/29/2018
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