Individual
MR. MARIO OSWALDO MARTIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
2446 TRIDENT WAY, SAN DIEGO, CA 92155-5494
(619) 437-0777
Mailing address
304 AGUA VISTA WAY, SAN DIEGO, CA 92114-5216
(619) 723-6724
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
01/27/2006
Last updated
07/08/2007
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