Individual
MATTHEW BAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3055 MINUTEMAN ST, SAN DIEGO, CA 92124-3624
(860) 639-7824
Mailing address
3055 MINUTEMAN ST, SAN DIEGO, CA 92124-3624
(860) 639-7824
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/20/2014
Last updated
07/20/2014
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