Individual
JONATHAN TABOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(161) 953-2796
Mailing address
1818 ROCKY SHORE RD, SAN DIEGO, CA 92139-1017
(404) 692-8338
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/07/2025
Last updated
04/07/2025
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