Individual
MR. JAMES E COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
35000 GUADALCANAL ST, BRANCH MEDICAL CLINIC MCRD, SAN DIEGO, CA 92140
(619) 524-4102
Mailing address
35000 GUADALCANAL ST, BRANCH MEDICAL CLINIC MCRD, SAN DIEGO, CA 92140
(619) 524-4102
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710I1002X
CORPSMAN
CA
Enumeration date
05/07/2008
Last updated
05/07/2008
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