Individual
NOEM CLAY GALLEGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
34101 BUILDING 14, FARENHOLT AVENUE, SAN DIEGO, CA 92134
(619) 532-9712
Mailing address
34101 BUILDING 14, FARENHOLT AVENUE, SAN DIEGO, CA 92134
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
1710I1002X
Independent Duty Corpsman
—
—
Other
Enumeration date
10/08/2015
Last updated
09/13/2021
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