Individual
RICARDO RENE KHALEEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(760) 977-1617
Mailing address
6303 LAKE COMO AVE, SAN DIEGO, CA 92119-3124
(760) 977-1617
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
K440-736-90-128-0
FL
Other
Enumeration date
04/03/2020
Last updated
04/03/2020
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