Individual
MR. MICHAEL RYAN HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(619) 532-9434
Mailing address
3075 SALMON ST, SAN DIEGO, CA 92124-3614
(805) 302-5574
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/04/2007
Last updated
07/29/2008
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