Individual
MR. JEFFREY J HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
3475 SENN RD BLDG 91, SAN DIEGO, CA 92136-5289
(619) 556-0488
Mailing address
3475 SENN RD BLDG 91, SAN DIEGO, CA 92136-5289
(619) 556-0488
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
CA
Other
Enumeration date
09/25/2012
Last updated
01/24/2019
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